• Title/Summary/Keyword: Transposition

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Clinical Roles of Continuous Lumbar Drainage in Acute Hydrocephalus Patients (급성 수두증 환자에서 지속적 요추지주막하 배액의 임상적 역할)

  • Yang, Geun Jin;Kim, Mun Chul;Chung, Hoon;Lee, Sang Pyung;Choi, Gi Whan;Yeo, Hyung Tae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.644-649
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    • 2000
  • Objective : Acute hydrocephalus can be caused by many pathologic conditions such as sub- arachnoid hemorrhage, intraventricular hemorrhage, inflammatory diseases. External ventricular drainage(EVD) through trephination of the skull is essential procedure for progressing or persistent symptomatic acute hydrocephalus. If the EVD can not be removed in short period, the chance of ventriculitis increases and periodic transposition of the draining catheter should be considered. Shunt procedure can not be performed in acute hemorrhage or infectious condition because of the risk of shunt malfunction or intra-abdominal spreading of the infection, respectively. The authors replaced EVD with continuous lumbar drainage(CLD) for the purpose of controlling acute hydrocephalus and preventing ventriculitis simultaneously, or treating ventriculitis more effectively in case of infection which had already broken out. CLD has many advantages over EVD, although, it can complicate disastrous downward brain herniation in patients with elevated intracranial pressure. The authors performed CLD with EVD maintained and then tested the possibility of the brain herniation with quite simple method. If the CLD was proven as safe through the test, EVD could be replaced with it without terrible herniation. Material and Method : Between September 1998 and April 1999, 10 patients underwent CLD in replacement of EVD. Among them, 5 were patients with aneurysmal subarachnoid hemorrhage, 2 were patients with thalamic hematoma and intraventricular hemorhage and 3 were patients with traumatic intracranial hemorrhage. Results : In eight of them the replacements were successfully done and one of them died on account of medical illness. In two of them the replacement could not be performed because of the risk of herniation and all expired owing to ventriculitis. Two patients required permanent shunt operation. Conclusion : This article provides a valuable alternative method of treatment for persistent symptomatic hydrocephalus which can not be managed with shunt operation immediately.

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Serial Changes of Cardiac Troponin I After Pediatric Open Heart Surgery (소아 개심술 환아에서의 Cardiac Troponin I의 변화)

  • Kim, Yeo Hyang;Hyun, Myung Chul;Lee, Sang Bum
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.208-213
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    • 2002
  • Purpose : The major cause of cardiac dysfunction, after open heart surgery for congenital heart disease, is perioperative myocardial injury. Cardiac troponin I is found only within the myocardial cell, so it can be used as a biochemical marker of the myocardial injury. We performed this study to evaluate the worth of cardiac troponin I as a biochemical marker reflecting the extent of perioperative myocardial injury and recovery. Methods : Thirty-four patients who had undergone elective open heart surgery of congenital heart disease(CHD) from April to July 2001 were enrolled in this study. We measured types of CHD, serial cardiac troponin I(baseline 1 day before operation, postoperative day 1, 2, 3, 7), duration of cardiopulmonary bypass(CPB), aortic cross clamping(ACC), intubation and postoperative hospital stay. Results : Compared with the baseline before operation, there was a significant, increase of cardiac troponin I on the postoperative day 1 and a significant gradual decrease on the day 2, 3, 7. The levels of cardiac troponin I were the highest in the transposition of great artery(TGA) repair on the postoperative day 1 and high in the tetralogy of Fallot(TOF), atioventricular septal defect (AVSD), ventricular septal defect(VSD) and atrial septal defect(ASD) repair with decreasing sequence. The longer duration of CPB, ACC and intubation, the higher of cardiac troponin I, but there were no significant correlations between cardiac troponin I levels and duration of hospital stay. Conclusion : Because there was significant increases or decreases of cardiac troponin I according to the perioperative time and types of the congenital heart disease, it is a worthy biochemical marker which reflects the extent of perioperative myocardial injury and recovery after open heart surgery.

The Early Results of Open Heart Surgery in Neonates (신생아기 개심술의 조기 성적)

  • Oh, Tak-Hyuck;Kim, Kyu-Tae;Kim, Gun-Jik;Lee, Jong-Tae;Cho, Joon-Yong
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.426-433
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    • 2009
  • Background: Remarkable progress has recently been made in achieving successful early repair of congenital heart disease with using cardiopulmonary bypass in the neonatal period. The aim of this study is to evaluate our short-term outcomes for performing neonatal cardiac surgery under extracorporeal circulation. Material and Method: Fifty five neonates underwent open heart surgery from February 2002 to December 2007. The mean ages and body weight was 13.5 days. and 3.2 kg, respectively. The diagnoses of the patients were transposition of the great arteries (14), total anomalous pulmonary venous connection (7), large ventricular septal defect (VSD) (7), coarotation of the aorta with VSD (6), interrupted aortic arch (5) and others (16). Result: Six patients had difficulties being weaned from extracorporeal circulation. Four patients left the operating room with an open sternum. Low cardiac output syndrome and acute renal insufficiency were observed in 3 patients each, respectively. Post-operative complications were observed in 27 patients (49.1%). The postoperative mortality was 12.7% (7 patients); 5 patients experienced early hospital death and 2 experienced late death (2). Conclusion: In our hospital, early surgical repair with extracorporeal circulation in neonates was feasible with tolerable mortality. Further follow-up required to establish the long-term survival and complications.

A Semilongitudinal Study on Cranial Base, Maxillary and Mandibular Growth of Korean Children Aging 7 to 17 Years Old (한국인 7-17세 아동의 두개저, 상악, 하악의 성장에 관한 준종단적 연구)

  • Sohn, Byung-Wha;Kim, Hyung-Soon
    • The korean journal of orthodontics
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    • v.29 no.1 s.72
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    • pp.23-35
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    • 1999
  • Lateral cephalograms or 251 males md 286 females were taken and pubertal growth pattern or cranial base, maxillary and mandible of 7 to 17 years old Korean children was evaluated. 10 landmarks and 16 analytical measurements were evaluated. Analytical measurement and annual difference for each age group was calculated and tested for statistical significance. Analytical measurements were classified into three groups which were cranial base, maxillary and mandibular measurements and also classified into make and female measurements. Following results were achieved. 1. The circumpuberal growth spurt was earlier in Korean females than in males. 2. Cranial base, maxilla and mandible showed circumpuberal growth. The cranial base showed a relatively smaller amount of growth than the facial complex. 3. Middle and posterior cranial base length showed a floater increase than anterior cranial base length and circumpuberal growth spurt was also more definite. 4. the forward and downward growth or maxilla results from maxillary growht itself and transposition or the maxilla due to circumsutural growth aroud the maxilla. Ar-ANS and Ar-Pr which represent maxillary position relative to the cranial base showed more growth than ANS-PNS which represents maxillary bone growth. 5. mandible showed more vertical growth than horizontal growth but without significance. 6. Alveolar gwoth of maxilla and mandible show maximum growth rate of the time of permanent teeth eruption following loss of deciduous teeth . After this period alveolar growth shows a decreasing tendency.

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THE NITROUS OXIDE CONCENTRATION IN BREATHING ZONE ACCORDING TO SCAVENGING METHODS DURING DEEP SEDATION OF PEDIATRIC DENTAL PATIENTS (소아치과 환자의 깊은 진정시 호기가스 제거 방법에 따른 호흡대역에서 Nitrous Oxide 농도 변화)

  • Lee, Chung-Won;Yoon, Hyung-Bae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.1
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    • pp.124-131
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    • 2003
  • The concentration of nitrous oxide in dental environment has increased especially in pediatric department. In pediatric department frequently met the behavior disordered patients who need the deep sedation. As the deeply sedated patients could not respond well to verbal command, the amount of mouth breathing would be increased especially with mouth prop which backward transposition of mandible. Inhalation of low concentration of nitrous oxide for a long duration has caused various side effects such as spontaneous abortion and inhibition of methionine synthetase activity which is harmful to DNA synthesis. For evaluation of factors of mouth breathing during deep sedation. The author measured the concentration of nitrous oxide in breathing zone by the change of the scavenging methods. One is drain the gas through the tail part of reservoir bag of Jackson Ree's system naturally. Another is scavenge from tail portion of reservoir bag with negative pressure. Last one is scavenge from nasal mask with negative pressure. The nitrous oxide concentration in breathing zone was the lowest in nasal part drainage but high above the recommended concentration of NIOSH. The order of nitrous concentration in breathing zone was: natural drainage, tail part with negative pressure, nasal part with negative pressure. This would reflect the order of resistance of nasal airway and showed the amount of mouth breathing. From the above experiment, the resistance of nasal airway by the increment of gas flow in corrugating tube and reservoir bag would be one of the causative factors of mouth breathing in deeply sedated patients.

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Prenatal Diagnosis of Chromosome 22q11.2 Deletions: Experiences in a Single Institution

  • Chae, Yong Hwa;Kwak, Dong Wook;Kim, Moon Young;Park, So Yeon;Lee, Bom Yi;Lee, Yeon Woo;Lee, Young Ho;Song, Mi Jin;Ryu, Hyun Mee
    • Journal of Genetic Medicine
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    • v.10 no.2
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    • pp.99-103
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    • 2013
  • Purpose: This study was designed to determine the frequency and echocardiographic findings of 22q11.2 deletions in fetuses with cardiac defects on fetal ultrasound or familial backgrounds of 22q11.2 deletions. Materials and methods: We retrospectively reviewed the medical and ultrasonographic records of 170 fetuses that underwent fluorescence in situ hybridization (FISH) analysis for chromosome 22q11.2 deletions between February 2001 and April 2013. Results: Among 145 fetuses with cardiac defects, six (4.1%) had 22q11.2 deletions. Deletions of 22q11.2 were detected in 6 (5%) of the 120 fetuses with conotruncal defects: 5 (8.9%) of 56 with tetralogy of Fallot (TOF) and 1 (5.9%) of 17 with double outlet right ventricle (DORV). No deletions were found in cases of pulmonary atresia, truncus arteriosus, right aortic arch, or transposition of the great arteries. No 22q11.2 deletions were found in non-conotruncal cardiac malformations. Among 25 fetuses with familial backgrounds of 22q11.2 deletions, one (4%) had a maternally inherited 22q11.2 deletion with no cardiac findings. Conclusion: Knowledge of the frequency and echocardiographic findings of 22q11.2 deletions might be helpful for prenatal genetic counseling. It is advisable to perform FISH analysis for 22q11.2 deletions in pregnancies exhibiting conotruncal cardiac defects such as TOF or DORV.

Detecting Spelling Errors by Comparison of Words within a Document (문서내 단어간 비교를 통한 철자오류 검출)

  • Kim, Dong-Joo
    • Journal of the Korea Society of Computer and Information
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    • v.16 no.12
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    • pp.83-92
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    • 2011
  • Typographical errors by the author's mistyping occur frequently in a document being prepared with word processors contrary to usual publications. Preparing this online document, the most common orthographical errors are spelling errors resulting from incorrectly typing intent keys to near keys on keyboard. Typical spelling checkers detect and correct these errors by using morphological analyzer. In other words, the morphological analysis module of a speller tries to check well-formedness of input words, and then all words rejected by the analyzer are regarded as misspelled words. However, if morphological analyzer accepts even mistyped words, it treats them as correctly spelled words. In this paper, I propose a simple method capable of detecting and correcting errors that the previous methods can not detect. Proposed method is based on the characteristics that typographical errors are generally not repeated and so tend to have very low frequency. If words generated by operations of deletion, exchange, and transposition for each phoneme of a low frequency word are in the list of high frequency words, some of them are considered as correctly spelled words. Some heuristic rules are also presented to reduce the number of candidates. Proposed method is able to detect not syntactic errors but some semantic errors, and useful to scoring candidates.

Ac/Ds-mediated gene tagging system in rice

  • Eun, Moo-Young;Yun, Doh-Won;Nam, Min-Hee;Yi, Gi-Hwan;Han, Chang-Deok;Kim, Doh-Hoon;Park, Woong-June;Kim, Cheol-Soo;Park, Soon-Ki
    • Proceedings of the Korean Society of Plant Biotechnology Conference
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    • 2005.11a
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    • pp.95-105
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    • 2005
  • Transposon-mediated insertional mutagenesis provides one of the most powerful tools for functional studies of genes in higher plants. This project has been performed to develop a large population of insertional mutations, and to construct databases of molecular information on Ds insertion sites in rice. Ultimate goals are to supply genetic materials and information to analyze gene function and to identify and utilize agronomically important genes for breeding purpose. Two strategies have been employed to generate the large scale of transposon population in a Japonica type rice, Dongjin Byeo; 1) genetic crosses between Ac and Ds lines and 2) plant regeneration from seeds carrying Ac and Ds. Our study showed that over 70% of regenerated plants generally carried independent Ds elements and high activity of transposition was detected only during regeneration period. Ds-flanking DNA amplified from leaf tissues of F2 and T1 (or T2) plants have been amplified via TAIL-PCR and directly sequenced. So far, over 65,000 Ds lines have been generated and over 9,500 Ds loci have been mapped on chromosomes by sequence analysis. Database of molecular information on Ds insertion sites has been constructed, and has been opened to the public and will be updated soon at http://www.niab.go.kr. Detailed functional analysis of more than 30 rice mutants has been performed. Several Ds-tagged rice genes that have been selected for functional analysis will be briefly introduced. We expect that a great deal of information and genetic resources of Ds lines would be obtained during the course of this project, which will be shared with domestic and international rice researchers. In addition to the Japonica rice, we have established the tagging system in an rice line of indica genetic background, MGRI079. MGRI079 (Indica/Japonica) was transformed with Agrobacteria carrying Ac and Ds T-DNA vectors. Among transgenic lines, we successfully identified single-copy Ds and Ac lines in MGR1079. These lines were served as ‘starter lines’ to mutagenize Indica genetic background. To achieve rapid, large scale generation of Ds transposant lines, MGR1079 transformants carrying homozygous Ac were crossed with ones with homozygous Ds, and $F_2$seeds were used for plant regeneration. In this year, over 2,000 regeneration plants were grown in the field. We are able to evaluate the tagging efficiency in the Indica genetic background in the fall.

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Early Results of Extracardiac Fontan Operation (심장외폰탄수술의 조기성적)

  • 김웅한;정도현;김수철;전홍주;이창하;김욱성;오삼세;정철현;나찬영
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.650-659
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    • 1998
  • Between August 1996 and August 1997, 22 patients underwent extracardiac Fontan operations. The basic diagnoses included univentricular heart of the right ventricular type (n=12); univentricular heart of the left ventricular type (n=4); tricuspid atresia (n=4); left isomerism, transposition of great arteries, ventricular septal defect and pulmonary stenosis (n=1); and criss-cross heart with uneven ventricle (n=1). The median age of the 14 men and 8 women was 29 months (range from 21 months to 26 years). Previous procedures included bidirectional cavopulmonary shunt (n=15, interval=15.6$\pm$3.4 months), Kawashima operation (n=4, interval=37.5$\pm$20 months), and classic Glenn shunt (n=1, interval=14 years). In 2 patients, extracardiac Fontan operations were done without any previous procedures. A 16- to 22-mm flexible Gore-Tex tube graft (n=18), Hemashield graft (n=3), or, alternatively, a nonvalved aortic allograft (n=1) was cut and anastomosed end-to-end between inferior vena cava and undersurface of pulmonary artery using Gore-Tex or Prolene suture in a running fashion. In risk Fontan patients (n=12), a communication between the extracardiac conduit and the right atrium was constructed. In the most 13 recent patients, the procedures were done without cross-clamping of the aorta and with a beating heart. Operative mortality was 9.1% (n=2). Complications included persistent chest tube drainage for more than 7 days (n=5), chorea (n=2), and low cardiac output (n=1). There were no late deaths. Follow-up echocardiogram (mean: 6 months) demonstrated satisfactory hemodynamic results in the surviving 20 patients. Potential advantages of this technique consist of minimization of surgical manipulation of atrial tissue, reduction or elimination of myocardial ischemia, creationof a uniform and stable inferior vena cava-to-pulmonary artery conduit, and increased flexibility and safety in certain high-risk patients such as those with increased pulmonary vascular resistance, pulmonary hypertension, and impaired ventricular function. Further investigations during a longer follow-up are needed to confirm the intermediate and long-term results, especially the reduction of late atrial arrhythmias.

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ORTHODONTIC TRACTION OF A TRANSPOSED IMPACTED MAXILLARY CANINE OF A DOWN SYNDROME PATIENT WITH CONGENITAL HEART DISEASE (심장질환이 있는 Down 증후군 환자의 전위 매복 치아 교정 치료 증례 보고)

  • Lee, Hyon Joo;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.8 no.2
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    • pp.118-121
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    • 2012
  • Down syndrome (DS) is a genetic disease known as trisomy 21. Congenital cardiac anomalies are present in about 40% of DS patients. Dental anomalies are also common among DS patients. In DS patients, canine impaction is 10 times more frequent and transposition of maxillary canine and first premolar is 50 times more common than in general population. A female DS patient with congenital heart disease was diagnosed as having a transposed impacted maxillary canine. Sectional fixed appliance with Nance holding arch was used for the orthodontic treatment. After space was regained for the eruption of the canine, orthodontic button was attached using flap operation with closed technique. Traction and alignment of the tooth followed. To prevent endocarditis, prophylactic antibiotics were prescribed for the recommended dental procedures. Total treatment time was 25 months and no complication was found.