• Title/Summary/Keyword: 동반진단치료

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Clinical Evaluation of Patients with Unilateral Non-functioning Kidney on $^{99m}Tc-DMSA$ scan ($^{99m}Tc-DMSA$ 스캔에서 일측성으로 동위원소 섭취가 안되는 환아들에 대한 임상적 고찰)

  • Bae Hyun-Chul;Kim Hyun-Young;Kim Pyung-Kil;Han Sang-Won
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.31-37
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    • 1997
  • The DMSA scan is a useful radiologic study in diagnosis of morphologic and functional diseases of kidney. We evaluated the distribution of sex and age, clinical manifestations, diagnosis, combined diseases, treatment and prognosis of the 61 patients with non-functioning kidney(no isotope uptake or uptake below 5% in DMSA scan) who admitted in our hospital from 1980 to 1995. The proportion of patients under 1 year old age was 46%. Sex ratio was 1.4:1 with male predominance. Most diagnosis of non-functioning kidneys were congenital such as multicystic dysplastic kidney, hydronephrosis due to ureteropelvic junction obstruction, renal agenesis and renal hypoplasia. In order of frequency thirty one percent of them were previously detected on antenatal ultrasonogram. Treatment consisted of operation in 47.5%, mostly nephrectomy and 32.8% of patients were followed up at OPD base without definite treatment. The most common combined diseases was hydronephrosis, in 4patients who had both kidneys inveloved progressed to chronic renal failure, but the prognosis in most cases were good. It is important to evaluate renal diseases in perinatal periods, and we believe that highly sensitive diagnostic study contribute to early treatment plan and thus to good prognosis.

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Pediatric Urolithiasis: Our 22-year Experience at a Single Center (소아에서의 요로결석: 단일기관에서 22년간의 경험)

  • Kim, Su-Yon;Kim, Min-Jee;Lee, Joo Hoon;Kim, Kun Suk;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.101-109
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    • 2013
  • Purpose: Pediatric urolithiasis is uncommon in children but is a cause of significant morbidity and damage to the kidney. Although much information on adult urolithiasis is available in the literature, large studies on the pediatric population are still scarce. In this report, we review our experience with pediatric urolithiasis over 22 years at a tertiary referral center. Method: We retrospectively reviewed the records of children with newly diagnosed urolithiasis between January 1991 and May 2013. We assessed the age, sex, family history, initial symptoms, location of stones, underlying cause, stone analysis, treatment, and recurrence among the patients. Results: In total, 137 patients (96 male, 41 female) were assessed. The age range was 0-17 years (mean age, 6.0 years). Forty-three (31%) children were aged <1 year, and 37% (16/43) had a history of intensive care unit (ICU) admission. Thirteen patients (9.5%) had a family history of stones. The most common symptoms at presentation among the patients were gross hematuria (56/137, 41%) and flank or abdominal pain (46/137, 34%). The stones were located in the kidney (85/137, 62%), ureter (29/137, 21%), bladder (2/137, 1.4%), and multiple locations (20/137, 15 %). Congenital abnormalities of the genitourinary (G-U) tract, with or without metabolic abnormality, or urinary tract infection (UTI) was detected in 26 children (19%). Ninety-one patients (66%) underwent metabolic examination, and 38% of these patients exhibited an abnormality. UTI, with or without abnormalities of the G-U tract, or metabolic abnormality was detected in 26 children (19%). Of the 35 stones analyzed, the majority were calcium stones (20/35, 57%), followed by infected stones (5/35, 14%), uric acid stones (4/35, 11%), carbonate apatite stones (3/35, 7%), cystine stones (2/35, 6%), and phosphate stones (1/35, 3%). Five patients (4%) required open procedures, with or without non-open procedures, whereas 77 patients (56%) were managed conservatively; the remaining 55 patients (40%) received some other form of intervention. Eighteen patients (13%) had stone recurrence during the follow-up period. Conclusions: Pediatric urolithiasis is commonly associated with abnormalities of the G-U tract and/or metabolic disorders and/or UTI. Half of the patients will pass their stones spontaneously, and all the techniques of minimally invasive surgery are applicable in the treatment of children with stones. As the recurrence rates are high among this population, long-term follow-up is recommended and the complete clearance of stones is important.

A literature review on diagnostic markers and subtype classification of children with speech sound disorders (원인을 모르는 말소리장애의 하위유형 분류 및 진단 표지에 관한 문헌 고찰)

  • Yi, Roo-Dah;Kim, Soo-Jin
    • Phonetics and Speech Sciences
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    • v.14 no.2
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    • pp.87-99
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    • 2022
  • A review regarding indicators used in Korean research is needed to develop a diagnostic marker system for Korean children with speech sound disorders (SSD). This literature review examined the research conducted to reveal the characteristics of children with SSD of unknown origin in Korea. The researchers in Korea used diverse variables as indicators to identify the natures of children with SSD. These included indicators related to external characteristics of speech sound and comorbid features other than external aspects of speech sound. The attention has been focused on specific indicators so far. This result implies that some indicators may still require closer study in various aspects due to their influence, and some may require more attention due to the limited number of research. This article argues that more research is necessary to comprehensively describe the unique characteristics of children with SSD of unknown origin and suggests a direction for future research regarding diagnostic markers and subtype classification of SSD. It also proposes potential diagnostic markers and a set of assessments for the subtype classification of SSD.

COMBINED ORTHODONTIC-SURGICAL TREATMENT FOR CLASS III PATIENT WITH MIDFACIAL DEFICIENCY AND MANDIBULAR PROGNATHISM (중안면부 함몰과 하악전돌을 동반한 III 급 부정교합자의 교정-악교정수술 복합치료)

  • Cho, Eun-Jung;Kim, Jong-Tae;Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.26 no.5 s.58
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    • pp.637-645
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    • 1996
  • In non-growing Class III malocclusion, the critical aspects which determine the need of orthognatic surgery are the severity of skeletal discrepancy, incisor inclination, overbile and soft tissue profile. Two-jaw surgery is more effective in correcting severe sagittal, vertical, transverse skeletal discrepancies and facial asymmetry. And more esthetic and stable profile can be achieved by two-jaw surgery Some midfacial deficiency Patients can be treated by Pyramidal Le Fort II osteotomy to maintain infraorbital rim and malar complex and to advance nasomaxillary complex. Others who require advancement of infraorbital rim and malar complex can be treated by quadrangular Le Fort II osteotomy. On the following cases, patients who had represented midfacial deficiency and mandibular prognathism were treated with combined orthodontic-surgical therapy by Le Fort II osteotomy and BSSRO.

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A Case of Moyamoya Disease Associated with Neurofibromatosis Type 1 in Patients with Renal Artery Stenosis and Hypertension (제 1형 신경섬유종증에 합병된 모야모야병에서 신장동맥 협착을 동반한 고혈압)

  • Seo, Young Ho;Yim, Hyung Eun;Yoo, Kee Hwan
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.143-148
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    • 2013
  • Neurofibromatosis type 1 (NF-1) is an autosomal dominant neurocutaneous disorder, which can affect different organs or systems of the body, including the cardiovascular system. One of the more serious aspects of the disease relates to arterial involvement. In particular, renal artery stenosis is one of the most common vascular abnormalities in patients with NF-1, and the manifestations vary, ranging from no symptoms to end-stage renal failure. Treatment usually consists of antihypertensive drugs, percutaneous transluminal angioplasty, or surgery. Other causes of hypertension should be ruled out and the patient followed up for close monitoring and proper management. We report a case of bilateral renal artery stenosis and hypertension in a patient with moyamoya disease associated with neurofibromatosis type 1. This report discusses the literature available on the current subject, its clinical features, diagnosis, and treatment.

Clinical Manifestation and Associated Cardiac Anomalies of Dextrocardia (우심증에 동반된 심기형과 임상양상)

  • Kim, Sung Hoon;Hong, Seung A;Cho, Yoon Jung;Lee, Sang Lak;Kwon, Tae Chan
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.622-628
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    • 2002
  • Purpose : The purpose of this study is to ascertain the clinical manifestations and associated cardiac anomalies of dextrocardia. Methods : Twenty-four pediatric patients, who were admitted to, or visited, Dongsan Medical Center Keimyung University and were diagnosed with dextrocardia between January 1996 and July 2001, were enrolled in this study. All patients received echocardiogram and abdominal ultrasonogram to identify structural cardiac anomalies and visceral position. Results : Among 24 patients, 7 cases were situs solitus(29.2%), 10 cases(41.6%) were situs inversus and 7 cases(29.2%) were situs ambiguous. Most were diagnosed within a week of life(87.5%). They were most commonly cyanotic(45.8%), but eleven cases(45.8%) had no specific symptoms or signs. Nineteen cases(79.2%) had accompanied cardiac anomalies, and pulmonary stenosis or atresia were the most common among them. All the cases of situs solitus and ambiguous had associated cardiac anomalies, but half of the situs inversus had that. Eleven cases were dead by cardiac or extracardiac anomalies during follow up and the mortality rate was higher in situs solitus or ambiguous group than situs inversus group. Conclusion : Dextrocardia accompanies different cardiac and extracardiac anomalies. It's very important to diagnose dextrocardia and associated cardiac or extracardiac anomalies in the early stages of life to improve prognosis.

Interdisciplinary approach on oral rehabilitation of an adolescent patient with multiple missing teeth: a clinical report (타과와의 협진을 통한 다수치 결손을 동반한 성장기 환자의 보철 수복 증례)

  • Kwon, Kung-Rock;Paek, Janghyun;Lee, Hyun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.339-346
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    • 2013
  • In case of missing of permanent teeth by trauma or innate defect, the decision of treatment modalities and application timing have an important effect on the prognosis of oral rehabilitation. In this case report, interdisciplinary approach between the orthodontic and prosthodontic treatment, the way to re-establish the collapsed occlusal vertical dimension, and implant prosthetic considerations will be discussed. Proper diagnosis on teeth and craniofacial skeleton was made prior to treatment and provisional restorations were used in regard of growth patterns of the patient. Finally, the edentulous areas were restored with fixed implant prostheses. Diagnosis, treatment rationale and prognosis will be discussed thoroughly.

Management of Biceps and Labral Disorders (이두 근 및 관절순 손상의 치료)

  • Choi, Chang-Hyuk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.110-116
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    • 2006
  • Lesion of the superior glenoid labrum and the insertion of the biceps tendon are a common cause for shoulder pain in patients performing overhead sports. Medial shearing stress during overhead throwing may cause biceps instability and associated rotator cuff problem aggravates the symptoms. Careful attention to the history and physical examination and may arouse suspicion of injury to the biceps tendon and the superior labral complex. Progress in shoulder arthroscopy has led to the identification of the lesion and normal variation. Treatment should be directed according to the type of lesion and related symptoms.

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Supraventricular tachycardia in a neonate with cardiac rhabdomyoma and tuberous sclerosis (상심실성 빈맥과 심장 종양으로 진단된 결절성 경화증 1예)

  • Bang, In Kug;Kim, Yeo Hyang;Kim, Chun Soo;Lee, Sang Lak;Kwon, Tae Chan
    • Clinical and Experimental Pediatrics
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    • v.51 no.7
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    • pp.766-770
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    • 2008
  • Primary tumors of the heart are uncommon among pediatric patients. Rhabdomyoma is the most frequent cardiac tumor in infants and children, which is commonly associated with tuberous sclerosis. Tuberous sclerosis is a neurocutaneous syndrome affecting the brain, heart, skin, and other organs. Cardiac rhadomyomas are reported in 50-64% of infants with tuberous sclerosis. Tuberous sclerosis involves multiple locations in the atrium, ventricle and septum, and may induce mechanical obstruction of the outflow tract and heart failure depending on the location, number, size, and degree of invasion of tumors. Arrhythmias may also develop in infants with cardiac rhadomyomas, but only a few of these patients require prolonged anti-arrhythmic therapy because arrhythmia often disappears with spontaneous regression of the tumors, and the ultimate prognosis may be decided by the cerebral manifestations.

A case of Kikuchi's disease with skin involvement (일과성의 홍반성 피부병변을 동반한 소아 Kikuchi병 1례)

  • Jang, Ji Min;Woo, Chul Hee;Choi, Jung Woo;Song, DaeJin;Yoo, Young;Lee, Kwang Chul;Son, Chang Sung
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.103-106
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    • 2006
  • Histiocytic necrotizing lymphadenitis, which is also commonly referred to as Kikuchi's disease (KD), is a self-limiting disease of unknown etiology. It affects individuals of all ages, although it is usually seen in young women. However, only a few descriptions of this disease are available in the pediatric literature. KD is clinically characterized by cervical lymphadenopathy, high fever, myalgia, neutropenia and, rarely, cutaneous eruptions. Cutaneous manifestations have been reported in 16-40 percent of KD cases. The specific skin changes occurring in cases of KD have yet to be completely characterized. In most of the reported cases thus far, the lesions have been located on the face and upper extremities. In this report, we describe a case of pediatric Kikuchi's disease, occurring in a 9-year-old boy. The boy exhibited transient erythematous maculopapular skin lesions over the entirety of his body, including his lower extremities.