• Title/Summary/Keyword: 관폐쇄

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Natural Course of Atrial Septal Defect Diagnosed Within the First 4 Weeks of Life (4주 이하 신생아에서 진단된 심방중격결손의 자연경과에 관한 연구)

  • Hwang, Young Jun;Chung, Kyung Hyun;Choi, Suk Min;Lee, Kyu Hyung
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.609-614
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    • 2002
  • Purpose : The purpose of our investigation was to explore the natural course, and the factors that influence the natural course, in ostium secundum atrial septal defect(ASD) diagnosed within the first 4 weeks of life. Methods : We studied patients with ASD diagnosed within the first 4 weeks of life during the period from September 1995 to September 1999 in our hospital. The diagnosis and measuring of the size of ASD was carried out by two-dimensional echocardiogram(2DE, Hewlett-Packard Sonos $2500^{(R)}$) from subcostal long and short axis views. Results : There were 61 patients - 29 males and 32 females. According to the size of their defects, we divided them into four groups; group A(less than 4 mm : 24 cases), group B(four mm-six mm : 27 cases), group C(six mm-eight mm : six cases), group D(more than eight mm : four cases). In groups A and B, 22 of 24 patients(91.7%) and 23 of 27 patients(85.2%) had each closed spontaneously. In group C, four of six patients had closed spontaneously. In group D, no patient had closed spontaneously and three of four patients had been closed surgically. There were significant differences in the rate of spontaneous closure between less than six mm group and more than six mm group in the size of the defect(P<0.05). There were no significant differences in the rate of spontaneous closure between ASD combined with simple cardiac defect and isolated secundum ASD. Conclusion : We conclude that defects smaller than six mm in diameter are very likely to close spontaneously.

Influence of Obstructive Sleep Apnea on Soluble Intercellular Adhesion Molecule-1 and Vascular Endothelial Growth Factor (폐쇄성 수면 무호흡이 Soluble Intercellular Adhesion Molecule-1과 Vascular Endothelial Growth Factor에 미치는 영향)

  • Kim, Jeong Pyo;Lee, Sang Haak;Kwon, Soon Seog;Kim, Young Kyun;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak;Moon, Hwa Sik
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.4
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    • pp.364-373
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    • 2004
  • Background : Obstructive sleep apnea is a contributory factor of hypertension, arrhythmia, ischemic heart disease and other cardiovascular diseases. However, the pathophysiology underlying this relationship is unclear. Recent reports have shown that the soluble intercellular adhesion molecule-1(sICAM-1) and vascular endothelial growth factor(VEGF) are involved in the initiation and progression of atherosclerosis, and some reports state that increased levels of these cytokines are found in patients with obstructive sleep apnea. In this study, the levels of sICAM-1 and VEGF were measured in patients with obstructive sleep apnea in order to determine if obstructive sleep apnea is involved in the pathophysiology of cardiovascular diseases. Methods : Thirty-seven patients were chosen amongst a population who visited the Sleep Disorders Clinic of St. Paul's Hospital in Seoul, Korea for a diagnosis of obstructive sleep apnea and who had subsequently undergone an overnight polysomnography at the clinic. The sera from these patients were retrieved after an overnight polysomnography session and the samples were kept at $-70^{\circ}C$. The cytokine levels were determined with ELISA and the relationships between the serum levels of sICAM-1 and VEGF along with polysomnography parameters were analyzed. Results : No statistically significant correlation was observed between the sICAM-1 levels and the apnea-hypopnea index(r=0.27, P>0.05). Positive correlations were found between the apnea-hypopnea index and serum VEGF levels (r=0.50, P<0.01), the apnea index and the serum sICAM-1 levels (r=0.31, P<0.01), and the apnea index and the serum VEGF levels (r=0.45, P<0.01). Conclusions : Obstructive apnea or hypopnea leads to an increase in the sICAM-1 and VEGF levels. Such an increase in the cytokine levels most likely leads to the higher incidence of cardiovascular diseases observed in patients with obstructive sleep apnea.

SURGICAL REPAIR OF COMPLETE BONY BILATERAL CHOANAL ATRESIA VIA TRANSPALATAL APPROACH (완전 골성 양측성 후비공 폐쇄 환자의 구개부를 통한 외과적 치험례)

  • Kim, Kyoung-Won;Cho, Yong-Seok;Yang, Soo-Nam
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.2
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    • pp.133-138
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    • 1998
  • Choanal atresia may be membrane or bony, unilateral or bilateral. Approximately 90% of the choanal atresia are bony type. Unilateral choanal atresia often eludes the diagnosis because of the absence of subjective symptoms in the neonatal period. However, bilateral choanal atresia presents at birth with cyclic respiratory distress aggravated by feedings. So complete bilateral choanal atresia is considered as a neonatal emergency. Examinations for the diagnosis of chonal atresia include 1) attempt at passing a rubber catheter or probe through the patient s nose, 2) mirror examination of the nasopharynx, 3) digital examination of the nasopharynx, 4) X-ray examination after installation of radiopaque materal into the nasal cavity. But, computed tomography has become accepted method for evaluation of choanal atresia. Surgical repair of choanal atresia is accomplished via transnasal or transpalatal approach. Advantages of the transpalatal approach are improved exposure and the preservation of mucosal flap along the newly formed apertures. On the other hand, the transpalatal approach carries the risk of injury to the greater palatine neurovascular complex, and requires longer operative time. After careful physical and radiographic examinations, we accomplished the surgical repair of the complete bony bilateral choanal atresia via transpalatal approach without complications.

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Nutrient Environment of Japanese Cedar(Cryptomeria japonica) -I. Changes of Soil Chemical Properties in Grasslands Afforestation (제주도(濟州道) 삼나무(Cryptomeria japonica) 조림지(造林地)의 영양환경(營養環境)에 관(關)한 연구(硏究) -I. 원야조림(原野造林)에 의한 토양성질(土壤性質)의 변화(變化))

  • Jin, Hyun-O
    • Korean Journal of Soil Science and Fertilizer
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    • v.24 no.3
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    • pp.177-182
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    • 1991
  • This study was carried out to clarify the effects of grassland afforestation on some chemical properties of the Japanese ceder(Cryptomeria japonica) forest soil in Cheju Island. The following results were obtained in this study ; 1. T-C, T-N, exch. cations and base saturation in the surface soil(0~10cm) decreased sharply from planting to crown closure. However, after crown closure, exch. Ca and Mg increased considerably. On the other hand, there were no definit changes below surface soil. 2. In vertical distribution of chemical properties, T-C, T-N, exchangeable acidity and exch. cations decreased with soil depth. Especially, exch. Ca and Mg of surface soil in closed stand show a higher value than that in open stand, but there were no variation below surface soil. 3. In closed stand, the amounts of exch. Ca, Mg and K were 1.8 times, 1.6 times and 1.5 times greater than those in open stand. There was no significant difference between open and closed stand in T-C and T-N. 4. The ratios of the amounts of nutrients in surface soil to those in mineral horizons(ha, 50cm) between the open and closed stand showed 30% and 50% for exch. Ca, 30% and 40% for exch. Mg, 38% and 38% for exch. K, respectively.

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Intestinal pseudo-obstruction as the initial presentation of systemic lupus erythematosus in a 13-year-old girl (장 가성 폐쇄로 진단된 전신 홍반 루푸스 1예)

  • Cho, Ky Young;Khil, Tae Young;Ahn, Hye Mi;Lee, Sun Wha;Seo, Jeong Wan
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.655-659
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    • 2008
  • Intestinal pseudo-obstruction (IPO) is a rare and poorly understood manifestation of systemic lupus erythematosus (SLE), especially in children. The characteristic clinical feature of IPO is obstruction without an identifiable obstructive lesion. The authors a 13-year-old girl whose first symptom of SLE was IPO. The patient presented with a 3-day history of nausea, bilious vomiting, abdominal distention, and no bowel movement. Simple abdominal radiographs revealed mild dilatation with partial air-fluid levels in the small intestine. Abdominal CT and methylcellulose small bowel studies showed massive ascites, engorgement of the small mesenteric vessels, pleural effusion, and diffuse bowel wall thickening of the gastric antrum, duodenum. and jejunum. The delayed passage of contrast for 15 days after the methylcellulose small bowel studies was suggestive of decreased bowel motility. Laboratory findings were positive for ANA, anti-double-stranded DNA, anti-Smith and lymphopenia. After 10-day treatment with high-dose corticosteroids, the symptoms improved. IPO associated with SLE should be considered in the differential diagnosis for patients presenting with symptoms of intestinal obstruction. Early recognition of IPO in SLE and appropriate therapy are important for prevention of complications and unnecessary surgery. This case raises awareness among pediatricians that although rare, IPO can be the presenting symptom of SLE in children.

Radiologic Analysis of Congenital Origin Intestinal Obstruction in Neonate and Childhood (선천성 장관폐쇄의 방사선학적 분석)

  • Hwang, Mi-Soo;Byun, Woo-Mok;Kim, Sun-Yong;Chang, Jae-Chun
    • Journal of Yeungnam Medical Science
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    • v.4 no.1
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    • pp.33-42
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    • 1987
  • Congenital origin intestinal obstruction are important disease due to required emergency operation. So accurate and rapid diagnosis is needed for decreased mortality and morbidity. Radiologist must detect to accurate obstruction site and also associated other congenital anomalies. And also embriological bases are very important role to the diagnosis of theses diseases. We were analysed radiologically and clinically 25 cases with congenital origin intestinal obstruction with review of literature. 1. Hypertrophic pyloric stenosis 6 cases, midgut malrotation 4 cases, congenital megacolon 8 case, imperforated anus 5 cases, ileal atresia 1 case and duodenal atresia 1 case. 2. Male and female radio were 16:9. Especially on hypertrophic pyloric stenosis, 5 cases were male infants. 3. All cases of hypertrophic pyloric stenosis represented string sign and also pyloric beak sign shoulder sign on UGI. 4. I case duodenal atresia showed double bubble sign on simple abdomen x-ray and ileal atresia showed mechanical small bowel obstruction sign with microcolon. 5. On midgut malrotation, cecum was located in right upper abdomen on 4 cases. And 2 cases were associated with Ladd's band. I case with volvulus and 1 case with mesenteric defect. 6. Involved site of all congenital megacolon were localized to rectosigmoid colon. 7. On 5 cases imperforated anus, 3 cases were low type and 2 case high type. Rectoperineal and rectourogenital fistula were demonstrated on 4 cases.

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Level of Obstructive Sleep Apnea of Patients with Ischemic Cardio-cerebrovascular Disease and Affecting Factors (허혈성 심뇌혈관질환자에서 폐쇄성 수면무호흡증 정도 및 영향요인)

  • Kim, Sun Hwa;Hwang, Seon Young
    • The Journal of the Korea Contents Association
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    • v.18 no.4
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    • pp.114-127
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    • 2018
  • This study aimed to investigate the levels of Obstructive Sleep Apnea (OSA), health behavior and sleep quality and to examine the predictors of OSA in patients with ischemic cardio-cerebrovascular disease. 141 patients who were admitted to the vascular unit were recruited and surveyed using structured questionnaires. Saturation of Peripheral Oxygen (SpO2) was measured at three time points using a pulse oximeter. Data were analyzed using SPSS/WIN 20.0. The mean age of the subjects was $64.4{\pm}11.1$ years and 61% was men. The 21.3%(n=30) of the subjects were classified as high-risk for OSA by the cut point and 71.6%(n=101) had low sleep quality. OSA high-risk group showed significant difference in SpO2 in the middle of sleep (p=.006) and at the end of sleep (p=.004) compared to the low-risk group. Multiple logistic regression analysis showed that perceived frequent snoring, smoking, obesity, lack of exercise among health behavior were found as predicting factors on OSA. OSA or persistent snoring should be recognized as a cardiovascular risk factor in the cardiovascular nursing practice. In addition to early treatment of OSA, education and counseling should be provided to patients and their family for prevention of secondary recurrence.

Role of Dacryoscintigraphy in the Diagnosis and Treatment of Pediatric Patients with Epiphora (유루를 호소하는 소아 환자의 진단 및 치료에서 누비공신티그라피의 역할)

  • Jeong, Hwan-Jeong;Bom, Hee-Seung;Song, Ho-Cheon;Min, Jung-Jun;Kim, Ji-Yeul;Jeong, Sang-Ki;Park, Yeoung-Geol
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.362-367
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    • 1999
  • Purpose: We conducted this study to evaluate the role of dacryoscintigraphy in the diagnosis and treatment of pediatric patients with epiphora. Materials and Methods: In 58 patients aged from 2 months to 15 years (mean age $2.8{\pm}2.3$ years), dacryoscintigraphy was performed using a gamma camera with 4 mm pinhole collimator. We correlated symptoms with dacryosicntigraphic findings in all patients. In 37 patients who underwent ophthalmologic procedures, we analyzed the agreements of dacryoscintigraphic findings with the operation. Results: High rates of agreements between epiphora and obstruction on dacryoscintigraphy (69/72, 95.8%), and between scintigraphic obstructive findings and operation sites (44/47, 93.6%) were noted. Nine of foully-four (20.5%) asymptomatic eyes showed obstructive findings on dacroscintigraphy. Conclusion: In pediatric patients with epiphora, dacryoscintigraphy is a useful tool not only in diagnosing nasolacrimal duct obstruction but also in making a decision for therapeutic procedures.

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Successful Opening of Ductus Arteriosus with Milrinone in a Newborn with Tetralogy of Fallot and Pulmonary Atresia

  • Won, Chong-Bock;Kim, Min-Young;Choi, Duk-Young;Cho, Hye-Jung;Shim, So-Yeon;Son, Dong-Woo
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.365-369
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    • 2011
  • Tetralogy of Fallot (TOF) assumes its' most severe form when accompanied by pulmonary atresia (PA). Preserving the patent ductus arteriosus to maintain pulmonary blood flow is life-saving for patients with this congenital heart disease. Milrinone, a selective phosphodiesterase III inhibitor, is a potent vasodilator. Here, we report the successful use of milrinone for a newborn infant with TOF and PA for keeping the ductus arteriosus open and thereby maintaining pulmonary circulation. Milrinone is a useful drug because of its inotropic, lusitropic, and pulmonary vasodilating effects, in addition to its ability to keep the ductus arteriosus open and its relatively mild side-effects. Case series and comparative studies will be needed in the future to verify the effectiveness of this drug.

Feasibility of Dacryoscintigraphy in Normal Dogs (정상 개에서 누비공신티그라피의 적용)

  • Cho, Young-Kwon;Lee, Ki-Chang
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.559-564
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    • 2010
  • The purpose of this study was to evaluate the value of dacryoscintigraphy with Tc-99 m Pertechnetate, which is useful in functional nasolacrimal duct obstruction diagnosis in human medical science, by applying it to normal dogs. Dacryoscintigraphy was performed on six clinically healthy beagle dogs to confirm normal passage of their lacrimal ducts. The scintigraphic images of both lacrimal system were obtained at 5 min, 10 min, and 20 min after Tc-99 m Pertechnetate administration, respectively. If lacrimal duct does not come into view within 20 min, delayed images at 30min, 45min and 60 min were gained. After drawing ROI of left and right canaliculus, lacrimal sac, and nasolacrimal duct acquired after dacryoscintigraphy, we measured each counting rate and developed a counting rate table for each time interval. Of the total of 12 places, 10 (83.3%) showed patency within 20 min, and 11 (91.6%) showed patency within 30 min. In one dog, a functional obstruction of right lacrimal canal was observed. Dacryoscintigraphy could provide useful information about functional and anatomical lacrimal duct obstruction in veterinary medicine as well as in clinical research.