• Title/Summary/Keyword: Pediatric surgery

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A study on injuries in deciduous teeth and permanent teeth (유치와 영구치의 외상에 관한 연구)

  • Lee, Mi-Ra;Ji, Min-Gyeong;Min, Hee-Hong
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.1
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    • pp.127-136
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    • 2011
  • Objectives : The writer aimed to examine the dynamic aspect on damage and to be conducive to the swift cure according to right treatment to educate prevention of injury through surveying on the number of the damaged teeth given injury, tooth kind, type in damage, place and cause for being damaged, frequency by month and by time level, and location of the damaged tooth. Methods : Targeting 343 teeth of receiving injury in 201 patients who visited the department of pediatric dentistry, the department of preservation, and the oral and maxillofacial surgery in a dental hospital in Cheonan city from April 2007 to April 2009, by having the dental injury as the main reason, the following conclusions were obtained. Results : 1. Deciduous teeth were indicated to be the highest in imperfect luxation with 60.7%, and were indicated to be in order of crown fracture with 25.5%, root fracture with 12.4%, and perfect luxation with 1.4%. The permanent teeth were indicated to be the highest in crown with 58.1%, and were indicated to be in order of imperfect luxation with 27.3%, root fracture with 13.1%, and perfect luxation with 1.5%(p<0.001). 2. In case of deciduous teeth for a place with damage, the home was indicated to be the highest with 31.7%. The permanent teeth were indicated to be the highest(p<0.001) in the road and stairs with 40.4%. As to a cause for damage, both deciduous and permanent teeth were indicated to be the highest(p<0.001) in a cause for falling with 53.1% and 30.8%, respectively. 3. As for a treatment method, in case of deciduous teeth, the close observation was indicated to be the highest with 46.9%. In permanent teeth, the resin restoration was indicated to be the highest(p<0.001) with 22.2%. Dental injuries in deciduous teeth and permanent teeth are showing diverse aspects. Conclusions : It is important to arrange guidelines on cure of the damaged teeth by injury through continuing a dynamic research on these aspects. Also, the damage in deciduous teeth may have direct and indirect influence upon growth in successional permanent teeth. Thus, through careful treatment, the injury needs to be minimized. It is considered to be likely necessary for a right coping method when injury occurs, and above all, for enough prior education so that injury cannot occur.

Optimal Timing of Surgery of Hydronephrosis Due to Ureteropelvic Junction Obstruction in Neonates and Infants (영유아의 신우 요관 이행부 폐쇄로 인한 수신증의 적절한 수술시기)

  • Ha, Seung Ju;Jung, Ji Hyun;Lee, Byeong Seon;Kim, Kun Seok;Moon, Dae Hyuk;Park, Young Seo
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.223-231
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    • 2002
  • Purpose : We review our experience with pyeloplasty for unilateral ureteropelvic junction obstruction of moderate to severe hydronephrosis observed by prenatal ultrasonography to assess the appropriate timing of operation for recovery of renal function and obstruction. Methods : We retrospectively reviewed the records of the total 28 patients who underwent pyeloplasty between 1995 and 2001 at Asan Medical Center. We compared pre and postoperative differentials in renal function and diuretic renogram as measured by technetium-99m-mercaptoacetyl-triglycerine scan and the degree of hydronephrosis by renal ultrasonography. Results : In all 28 patients postoperative follow-up renal ultrasonography revealed significant improvement in hydronephrosis. In 10 poorly functioning hydronephrotic kidneys in which relative renal function function was less than 35%, renal function was improved postoperatively in 3 cases, but not improved in 7 cases. In all 28 patients postoperative follow-up diuretic renogram revealed significant improvement. Conclusion : We believe that the early pyeloplasty should be considered when ultrasonography and diuretic renography suggest obstruction because renal function does not improve significantly after pyeloplasty over preoperative value.

Contribution of Macrophage Migration Inhibitory Factor -173G/C Gene Polymorphism to the Risk of Cancer in Chinese Population

  • Wang, Cheng-Di;Li, Tai-Ming;Ren, Zheng-Ju;Ji, Yu-Lin;Zhi, Liu-Shou
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4597-4601
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    • 2015
  • Background: Macrophage migration inhibitory factor (MIF) -173G/C (rs755622) gene polymorphism has been associated with cancer risk. Previous studies have revealed that MIF -173G/C gene polymorphism may increase cancer in the Chinese population, while results of individual published studies remain inconsistent and inconclusive.We performed this meta-analysis to derive a more precise estimation of the relationship. Materials and Methods: We conducted a search on PubMed, Embase, MEDLINE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Wanfang, Weipu on Dec 31, 2014.Odds ratio (OR) and 95% confidence interval (95% CI) were used to assess the association. A total of eight studies including 2,186 cases and 2,285 controls were involved in this meta-analysis. Results: The pooled results indicated the significant association between MIF -173G/C polymorphism and the risk of cancer for Chinese population (CC + CG vs GG: OR=1.14, 95%CI=1.02-127, pheterogeneity<0.01; P=0.023; CC vs CG+GG: OR=1.12, 95%CI=1.02-1.23, pheterogeneity<001; P=0.017;CC vs GG: OR=1.18, 95%CI=1.04-1.33, pheterogeneity<001; P=0.008; CG vs GG:OR=1.03, 95%CI=0.91-1.15, pheterogeneity<001; P=0.656; C vs G:OR=1.24, 95%CI=1.14-1.25, pheterogeneity<001; P<001). Subgroup analysis showed that in patients with "solid tumors", heterogeneity was very large (OR=0.94,95%CI=0.83-1.06,pheterogeneity=0.044; p=0.297). Within "non-solid tumors", the association became even stronger (OR=6.62, 95 % CI=4.32-10.14, pheterogeneity<0.001; p<0.001). Conclusions: This study suggested that MIF -173G/C gene polymorphism may increase increase cancer in the Chinese population.Furthermore, more larger sample and representative population-based casees and well-matched controls are needed to validate our results.

A survey on the nonpharmacologic nursing intervention for children in pain (통증 환아를 위한 비약물적 간호 중재 방법 조사)

  • Yoon Hea Bong;Cho Kyoul Ja
    • Child Health Nursing Research
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    • v.6 no.2
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    • pp.144-157
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    • 2000
  • This study was done to understand nonpharmacologic pain management for pediateric patients and nurses' knowledge and attitudes toward it. The aim of this study was that which method did the patient's use according to the nurses' age, and how did they effectively use these methods in their field. The subjects of this study were 77 nurses working in the Pediatric unit in the Kyung Medical Center from September 2 to 15, 1999 using questionnaire form. The results of this study were as follows : 1. We divided the subjects into four groups : Younger than one year old, 1-6 years, 6-12 years, 12-18 years group. In the group younger one year old, most of the nurses participating in this study used speaking in soft quiet tones, supportive touch, toys, pacifiers. In the group of 1-6 years, they used speaking in soft quiet tones, toys, distracting attention, story talking, and visual stimulus. In the group of 6-12 years. they used pop-up books, providing information, cold therapy, speaking in soft quiet tones, supportive touch. In the group of 12-19 years, most of them used providing information, controling respiration and supportive touch. 2. The effective nursing intervention used in their field are speaking in soft quiet tones, pacifiers and nesting with blanket in the group of younger than one year old. Un the group of 1-6 years old, speaking in soft quiet tones, toys, and supportive touch were effective method in the control of nonp-harmacologic pain management. In the group of 6-12 years old, story talking, supportive touch, and speaking in soft quiet tones were effective method and in the group of 12-18 years old, providing information, cold therapy and supportive touch were effectively used to control nonpharmacologic pain management. 3. To compare the general characteristics and non-pharmacologic pain nursing intervention, in the group of younger than one year, touching stimuli is widely used. In the groups of 1-6, and 6-12 years old, visual and audio method were widely used. In the group of 12-18 years old, sensitive intervention were used as well as education, information and guided imagery. In conclusion, there was no significant difference in nurses' demographic characteristics, child's age and nonpharmacologic pain management. There was significant difference only in the nurses working area, that is nurses working in the surgical department used more audio-visual-tactile pain management methods than medical department.

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A case of hippocampal sclerosis diagnosed as cortical dysplasia due to preoperative brain MRI finding (수술 전 뇌 자기공명 영상에서 겉질 형성이상증 소견 보였으나 수술 후 병리학적으로 확인된 해마경화증 1례)

  • Lee, Jun Seok;Kim, Kyo Ryung;Kim, Jeong Tae;Choi, Min Jung;Lee, Young Mock;Kim, Heung Dong;Lee, Joon Soo;Kim, Dong Seok;Kim, Tae Seong
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.106-110
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    • 2010
  • Hippocampal sclerosis (HS) is one of the most common features of intractable temporal lobe epilepsy. Generally it can be identified through brain magnetic resonance imaging (MRI) with high degree of sensitivity and specificity. Typical brain MRI findings of HS are hippocampal atrophy with hyperintense signal confined to the lesion. On the other hand cortical dysplasia exhibits blurring of the gray-white matter junction and abnormal white matter signal intensity. We present a case where preoperative brain MRI strongly suggested the presence of diffuse cortical dysplasia in the left temporal lobe but postoperative pathology revealed the temporal lesion to be unremarkable except for hippocampal sclerosis.

Clinical Outcome and Follow-up of Neonatal Hydronephrosis Diagnosed Antenatally (산전 진찰에서 진단된 신생아 수신증에 대한 추적 관찰)

  • Park, Su-Eun;Kim, Su-Yung
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.161-168
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    • 1998
  • Purpose : Lots of congenital anomalies of urinary tract including hydronephrosis are detected in fetus and neworn by popular use of prenatal ultrasonography. But there are little data available in Korea about natural course of hydronephrosis diagnosed antenatally by ultrasonography. So we intended to help management of these patients by analizing the follow up data of the neonates with hydronephrosis diagnosed antenatally. Methods : We evaluated 22 patients with neonatal hydronephrosis(33 renal units) who were diagnosed prenatally and confirmed postnatally. Especially patients with suspected ureteropelvic junction obstruction were followed regulary with renal ultrasonography and diuretic renography for 8-24 months. Results : 1) The etiologies of neonatal hydronephrosis diagnosed prenatally were suspected ureteropelvic junction obstruction($69.9\%$), vesicoureteral reflux($15.1\%$), primary megaureter($3.0\%$), double ureter with ureterocele($3.0\%$), ureteral stricture($3.0\%$), multicystic dysplastic kidney(3.0$\%$), and ureterovesical junction obstruction(3.0$\%$). 2) The follow up results of 23 renal units of suspected ureteropelvic junction obsruction: Except 4 renal units with palpable abdominal mass, of the remained 19 renal units, 14 units($73.6\%$) were improved spontaneously, 3 units($15.7\%$) remained stable, only2 units($10.5\%$) were aggravated. Conclusion : We concluded that in most cases of hydronephrosis there is no need for immediate surgery, and that nonoperative approach, using serial ultrasonography and diuretic renogram, is safe management of neonatal hydronephrosis diagnosed anteratally.

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A case of Smith-Lemli-Opitz syndrome diagnosed by identification of mutations in the 7-dehydrocholesterol reductase (DHCR7) gene (7-dehydrocholesterol reductase (DHCR7) 변이로 진단된 Smith-Lemli-Opitz 증후군 1예)

  • Park, Mee Rim;Ko, Jung Min;Cheon, Chong-Keun;Kim, Gu-Hwan;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1236-1240
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    • 2008
  • Smith-Lemli-Opitz syndrome (SLOS) is a rare, autosomal recessive disease caused by an inborn error in cholesterol synthesis. Patients with this disease suffer from multiple malformations due to reduced activity of 7-dehydrocholesterol reductase (DHCR7), which increases 7-dehydrocholesterol (7DHC) and 8-dehydrocholesterol (8DHC) concentrations and decreases cholesterol concentration in body fluids and tissue. The SLOS phenotypic spectrum ranges from a mild disorder with behavioral and learning problems to a lethal disease characterized by multiple malformations. Here, we describe a newborn male with ambiguous genitalia who was diagnosed to have type II SLOS during the neonatal period. A clinical examination revealed low levels of unconjugated estriol in the maternal serum, and a variety of fetal ultrasound anomalies, including prenatal growth retardation. After birth, the infant was diagnosed to have congenital heart disease (Tetralogy of Fallot with severe pulmonary artery stenosis), cleft lip and palate, micrognathia, postaxial polydactyly, ambiguous genitalia, and cataracts. Clinical investigation revealed extremely low plasma cholesterol levels and the presence of mutation (homozygote of p.Arg352Gln) in the DHCR7 gene. The patient underwent palliative heart surgery (to widen the pulmonary artery) and received intravenous lipid supplementation. Cholesterol levels increased slightly, but not to normal values. The patient died from cardiopulmonary failure and sepsis 72 days after birth. This report provides the first description of a Korean patient with SLOS confirmed by verification of DHCR7 gene mutation and illustrates the need for early recognition and appropriate diagnosis of this disease.

Postoperative Radiation Therapy of Craniopharyngioma (두개인두종의 수술후 방사선치료 성적)

  • Shin, Kyung-Hwan;Yun, Hyong-Geln;Kim, Il-Han;Park, Charn-Il;Cho, Byung-Kyu
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.59-67
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    • 1993
  • Between December 1979 and September 1989, 23 patients with craniopharyngioma who underwent surgery and postoperative radiation therapy were retrospectively evaluated to assess the efficacy of this management at the Department of Therapeutic Radiology, Seoul National University Hospital. Total removal of tumor was attempted in all patients. Of these, surgeons tried total removal in eight patients, but revealed residual mass by postoperative CT, and partial removal was done in 15 patients. The morphology of tumor on the operative finding was grouped into three types: cystic 13 ($57{\%}$), solid 4 ($17{\%}$), and mixed 6 ($26{\%}$). Cystic type was predominant in$\leq$20 years old group. Actuarial overall survival rates at 5 and 10 years were $95{\%}$ and $81{\%}$ respectively and actuarial tumor control rates were $74{\%}$ and $50{\%}$. Surgical extent was not related to the survival rates (p=0.41). Pediatric and adolescent patients (age of$\leq$20 years) had a trend of better survival than that of adult patients (p=0.10). The results indicated that limited surgical excision followed by radiation therapy is recommended when total excision is not possible.

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An Analysis and Assessment of Diagnostic and Therapeutic Process in Some Frequent Admissions and Operations (일부 다빈도 입원 및 수술례의 진단과 치료과정에 대한 연구)

  • Kim, Chang-Yup;Kim, Yoon;Kwon, Young-Dae;Kim, Yong-Ik;Shin, Young-Soo;Ahn, Hyeong-Sik
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.3 s.43
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    • pp.400-411
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    • 1993
  • The aim of this study is to analyze the variations among hospitals and hospital groups in resource use and procedures of diagnostic and therapeutic process, such as laboratory tests, radiologic examinations, tissue diagnosis, timing of surgery after admission, the time required for operation. The study was performed for five procedures including cesarean section (C/S), appendectomy, cholecystectomy, cataract extraction, and pediatric pneumonia. The 2,316 subjects were selected from medical insurance claims list, and from this list 413 cases were sampled for medical record review. The patterns of resource utilization and process of treatment were described according to hospitals and characteristics of hospital groups. The major results were as follows : 1. The numbers of laboratory and radiologic tests showed significant difference among hospitals and hospital groups. In case of hospital groups, we could find tendencies of more tests with increasing hospital bed size. 2. In general, the proportion of operative cases evaluated by tissue diagnosis postoperatively among all operations ranged from 28.3% to 100%. The proportion varied among hospital groups, of which general hospital A group(more than 15 specialty) showed the highest proportion. 3. Post-admission delay until operation and the time required for operative procedure were not invariable among hospitals and hospital groups. The duration of operation in tertiary hospitals was slightly shorter than general hospitals, with varying statistical significance. We could find that probably there were differences of quality among hospitals in some components of procedures, which suggested that the implementation of quality assurance activities would be mandatory. In this study, we simply described the patterns of resource utilization and some features of clinical process, with institution of the need for advanced studies with in-depth analyses for each component of diagnosis and treatment procedures.

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A Case of Renovascular Hypertension Due to Renal Artey Stenosis Related to Moyamoya Disease (모야모야병과 동반된 신 동맥 협착에 따른 신성 고혈압을 보인 1례)

  • Kim, Joung-A;Kim, Seung;Kim, Hyo-Sun;Shin, Jae-Il;Jeong, Il-Cheon;Kim, Dong-Seok;Kim, Myung-Joon;Lee, Do-Yun;Lee, Jae-Seung
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.294-298
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    • 2007
  • Moyamoya disease is a progressive cerebrovascular disorder with stenosis or occlusion of the bilateral internal carotid arteries with abnormal vascular networks at the base of the brain. Previous reports have shown that there are extracranial vascular involvements in Moyamoya disease, especially in the renal artery. We report a 7-year-old patient with Moyamoya disease associated with renovascular hyper tension, who presented in infancy with seizures and hemiparesis. Renal angiography showed multiple stenoses of the right renal artery. Although renal artery stenosis in Moyamoya disease has been effectively treated with balloon angioplasty, stent implantation, or surgery, bat-loon angioplasty could not be done in this patient due to multiple stenoses. His blood pressure was successfully controlled with medical treatment, and remained normotensive during the follow up period of 6 months.

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