• Title/Summary/Keyword: Congenital

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The Contributory Factors of CSF Shunt Failure (뇌실 복강간 단락 부전의 기여인자)

  • Kim, Young Don;Hwang, Sung Kyoo;Hwang, Jeong Hyun;Sung, Joo Kyung;Hamm, In Suk;Park, Yeun Mook;Kim, Seung Lae
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.79-84
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    • 2001
  • To investigate contributory factors of CSF shunt failure, 237 patients, who underwent shunt placement from January 1995 to December 1998 at our hospital, were reviewed retrospectively. The causes of the hydrocephalus were tumor, hemorrhage, infection, congenital anomaly, normal pressure hydrocephalus, trauma and others. One hundred nine revisions of CSF shunting were done during follow up periods. The causes of shunt revisions were mechanical obstruction, malposition, infection and others. The contributory factors of CSF shunt failure and shunt survival rate were analyzed using SPSS. The shunt survival rate at 1, 2 and 3 years after procedure was 77.1%, 75.4%, 74.1% respectively. In the young age group below 10 years old, postinfectous hydrocephalus was the most common high risk factor for shunt revision. In conclusion, the most shunt failures developed in the first year after surgery and the age and causes of the hydrocephalus were major determinant factors of shunt revision.

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Slit Ventricle Syndrome in Children : Clinical Presentation and Treatment (소아에서 틈새뇌실 증후군 : 임상 양상 및 치료)

  • Shin, Beom-Sik;Yang, Kook-Hee;Kim, Dong-Seok;Choi, Joong-Uhn
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.309-315
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    • 2001
  • The term slit ventricle syndrome(SVS) refers to an episodic occurrence of headache, vomiting, and possibly some degree of impaired consciousness in shunted hydrocephalic children in whom slit-like ventricles are seen on CT scan or MRI. Authors present 6 cases with SVS who were treated at our institute for last 10 years. From 1986 to 1996, 821 patients underwent shunt surgery for hydrocephalus. The etiology of hydrocephalus included brain tumor(140 patients), post-hemorrhagic(62 patients), idiopathic normotensive hydrocephalus(64 patients), post-meningitic( 58 patients), post-traumatic(54 patients), congenital(48 patients), neurocysticercosis(31 patients), and unknown etiology(364 patients). During the mean follow-up duration of 68 months, 232 shunt revisions were performed by a revision rate of 1.28 per patient. The incidence of SVS was 0.7%(6 patients). Most of them have been operated on in infancy. Time interval from the first operation to the development of slit-ventricle syndrome ranged from 4 to 8 years, the mean was 6 years. Shuntogram showed patent shunt in all patients. Two patients with less severe clinical symptoms improved with conservative treatment. These patients were not measured ICP because of good hospital course. One patient showed high ICP and needed only revision with same pressure valve as previous shunt. Low ICP was noted in 3 patients. Pressure augmentation using an anti-siphon device(ASD) or upgrading valve system were necessary in these patients. The authors stress that determining type of SVS is the first step in treatment planning and that the best treatment is a strategy aimed at resolving the specific type of SVS responsible for the symptoms.

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Deep Sedation with Sevoflurane in Patients with Double Outlet of Right Ventricle (양대혈관 우심실 기시 환아의 Sevoflurane을 이용한 깊은 진정 하 치과치료)

  • Hyun, Hong-Keun;Shin, Teo Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Kim, Hyun-Jeong;Seo, Kwang-Suk;Lee, Jung-Man;Shin, Soonyoung
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.2
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    • pp.115-119
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    • 2012
  • Double outlet of right ventricle (DORV) refers to a congenital heart disease in which pulmonary and systemic circulation originates from the right ventricle. In the patient with DORV, it is important to maintain the balance between pulmonary and systemic circulation in anesthetic management. A 4-year-old boy with DORV, who underwent a Blalock-Taussig shunt operation, was transferred to the clinic with a chief complaint of multiple caries. Due to poor cooperability, it was impossible to treat the caries without sedation or general anesthesia. We planned to sedate him with consideration with detrimental effects associated with positive pressure ventilation for dental treatment. After a prophylactic administration of antibiotics, sevoflurane was administered through T-cannula site. Throughout the treatment, His blood remained stable around 80/40 mmHg, oxygen saturation remained around 91%. After 3 hour of sedation with sevoflurane (end-tidal sevoflurane con 1-1.8 vol%), he fully regained consciousness, and discharged from hospital without complications. In case of DORV patient, deep sedation with sevoflurane may be used as effective method of behavioral management during dental treatment.

A Cephalometric Study of Lateral Morphologic Features in Adult Cleft Lip and Palate Patients (구순 구개열 환자의 성장후 측모형태에 관한 두부계측방사선학적 연구)

  • Chang, Ic-Jun;Sohn, Woo-Ill;Song, Jae-Chul;Chin, Byung-Rho
    • Journal of Yeungnam Medical Science
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    • v.18 no.1
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    • pp.112-122
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    • 2001
  • Background: Cleft lip and palate deformity have unknown patterns of maxillofacial growth and development. The maxillofacial growth can be affected either by congenital or environmental factors such as infection and trauma. Surgical repair of cleft lip and palate may interfere the subsequent growth and development of maxillofacial region. The purpose of this study is to evaluate the characteristics of maxillofacial growth patterns in adult cleft lip and palate patients. Materials and Methods: The material for this study consisted of 17 adult male patients with cleft lip and palate. Cephalometric tracing and measurements were done by one investigator. The relationship between 17 cleft lip and palate patients and Korean norms were evaluated statistically. Results: There were statistically differences in Na. perpendicular to point A, SNA angle, effective maxillary length, maxillofacial differencial. Wit's appraisal and upper incisor to point A(p < 0.01). Pogonion to Na. perpendicular also statistically differed(p < 0.05). Other measurements didn't statistically differ. Conclusion: It was evident that in adult cleft lip and palate patients, maxilla was retruded and short. Careful cleft lip and palate repair and treatment are recommended for facilitating normal growth of maxilla.

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Etiological Classification and Developmental Outcomes in Floppy Infants: A Single Tertiary Center Experience (늘어지는 영아 증후군의 진단적 분류와 발달 예후: 단일 3차 병원에서의 연구)

  • Park, Jung Min;Choi, Young Ha;Lee, Ha Neul;Chung, Hee Jung
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.189-196
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    • 2018
  • Purpose: Floppy infants or congenital hypotonia indicates decreased muscle tone in infants secondary to abnormalities of the central or the peripheral nervous system, or both. Previous literature classified its causes as those attributable to a central vs. peripheral origin; however, recent studies have introduced a newer classification describing a combined origin. We invenstigated floppy infants by applying the new etiological classification and reviewed the most common etiologies based on the age of presentation. We additionally reviewed the clinical characteristics, diagnoses, and the developmental outcomes in these infants. Methods: We retrospectively reviewed the electronic medical charts and recruited 116 infants diagnosed with floppy infant syndrome between January 2005 and December 2016 at Severance Children's Hospital. Among these infants, 66 with a confirmed diagnosis were reviewed for the etiological classification. Information regarding developmental outcomes was obtained via phone interviews with the infants' families. Results: Based on the new etiological classification, among 69 infants with a confirmed diagnosis, in 40 (34.5%) this syndrome was of central origin, in 19 (16.4%) of peripheral origin, and in 10 (8.6%) of combined origin. Prader-Willi syndrome, myotonic dystrophy, and spinal muscular atrophy were the most common disorders observed and combined hypotonia showed the poorest developmental outcome. Conclusion: The study states the importance of proper evaluation of etiological diagnosis and optimal intervention for developmental prognosis. The introduction of a new etiological group of combined hypotonia especially emphasizes regular monitoring and timely rehabilitative intervention in patients for the better quality of life in them as well as their caregivers.

A study of preservation of health in the ${\ulcorner}$Dongyi Bogam${\lrcorner}$ and ${\ulcorner}$Dongyi Soose Bowon Sasang Chobongyun${\lrcorner}$ ("동의보감(東醫寶鑑)"과 "동의수세보원사상초본권(東醫壽世保元四象草本卷)"에 나타난 양생관(養生觀)에 대한 고찰)

  • Lee, Soo-Kyung;Lee, Eui-Ju;Koh, Byung-Hee;Song, Il-Byung;Jeong, Yong-Jae
    • Journal of Sasang Constitutional Medicine
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    • v.14 no.2
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    • pp.25-34
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    • 2002
  • To understand characteristic of preservation of health in Sasang constitutional medicine, 1 first study preservation of health In ${\ulcorner}$Dongyi Bogam${\lrcorner}$, and then study preservation of health in the ${\ulcorner}$Dongyi Soose Bowon Sasang Chobongyun${\lrcorner}$ particularly Inherent vitality(命脈實數) and Regimen in ordinary life(生息充補之道) which shows early thought of Lee Je-ma. I acquire relation and difference between ${\ulcorner}$Dongyi Bogam${\lrcorner}$ and Dongyi Soose Bowon Sasang Chobongyun${\lrcorner}$, and conclude as follows. 1. In preservation of health ${\ulcorner}$Dongyi Bogam${\lrcorner}$ says Ups and downs of Qi according to degree, tells congenital health and acquired care of health, grades Jin-In, Ji-In, Seong-In, Hyeon-In according to degree of moral culture, and especially emphasizes managing mind which is based on Taoism. 2. In ${\ulcorner}$Dongyi Soose Bowon Sasang Chobongyun${\lrcorner}$ Dongmu divides human being to Sasangin(Taeyangin, Taeumin, Soyangin, Soeumin) according to Large & small of viscera, and regards as determine lift span and rendition of disease & health according to Inherent vitality which is degree of Small viscera. 3. Inherent vitality of Sasangin is supplemented by Regimen in ordinary life. Because Regimen in ordinary life decreases according to age, Dongmu emphasizes managing mind through an autonomic Knowledge Deed to maintain Regimen in ordinary life. 4. In the way of managing mind ${\ulcorner}$Dongyi Bogam${\lrcorner}$ says Taoist moral culture, but Dongmu emphasized control of knowledge and Deed by Confucian moral culture and the mind of control others through confucian self-control.

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Population Policy and Population Quality(Report 1. General Review on the Problems of Mental and Physical Handicaps) (인구정책과 인구자질향상을 위한 연구(제 1 보 심신장애자 발생억제대책))

  • Kim, Jong-Kun;Huh, Jung
    • Korea journal of population studies
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    • v.3 no.1
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    • pp.5-41
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    • 1979
  • Vast volumes of studies of the medical and public health aspects of fertility and family planning have been published by the various institutes of health related research and university scholars in Korea. None of them, however, have dealed with the population problems associated with biologically and mentally handicapped people. It must be emphasized that the purpose of Korea's population policy should be to improve the quality of the population rather than to decrease its rate of increase. In this spirit, the first report of this study is to identify problems related with mentally and physically less fitted population, and to attempt to offer the possible solutions to the health planners and policy-makers. Several nation-wide surveys of the handicapped people in Korea have been compared. Each survey shows a wide range of difference in the prevalence of the handicaps(see Table 13). In this study, the data on the handicaps are collected by two independent system ; one by the nation-wide survey and the other by the reporting system existing at the Seoul National University Demonstration Health Project. The Chandrasekar-Deming technique was used to estimate the total number of handicaps. The estimates are summarized in the tables 8, 9 and 10. Estimate of total number of handicapped people in Korea is 601, 400 with the prevalence rate of 16.1 per thousand persons. Even if taking a number of conditions which may result in a biased estimate of the total number of the handicaps into consideration, the proportion of handicapped people in Korea has increased in the past two decade as the result of the rapid decline in fertility and childhood mortality, which consequently prolonged life expectancy of persons with congenital or acquired impediment. An increase in the proportion of handicapped people will eventually bring about serious problems of social welfare, medical care, and population qualities from various aspects including eugenics. To tackle the problem, there must be an increased emphasis on the prevention of handicaps from the government and private sector. Based on the amount and quality of data, and from the practical point of view, this study prepared a set of recommendations for the government to strengthen its programs of the preventive activities during the prenatal period and early childhood, early finding from routine examinations, and proper social and medical rehabilitation.

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DENTAL TREATMENT OF A PATIENT WITH LOWE SYNDROME UNDER GENERAL ANESTHESIA: A CASE REPORT (Lowe syndrome 환아의 전신마취 하 치아우식 치료: 증례보고)

  • Kim, Min Jin;Song, Ji-Soo;Shin, Teo Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Hyun, Hong-Keun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.35-39
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    • 2019
  • Oculo-cerebro-renal syndrome, known as Lowe syndrome, is an X-linked gene disorder characterized by congenital cataracts, brain abnormalities and renal dysfunction. Tooth crowding, taurodontism, delayed eruption in the permanent dentition and over-retained primary teeth with ectopic eruption of the permanent teeth have been reported as dental findings. Because of the high incidence of poor cooperation, patients with Lowe syndrome have difficulties in maintaining good oral hygiene, which may require dental treatment. We present a case of dental treatment for the uncooperative child with Lowe syndrome under general anesthesia. A 4-year-old, 11.2 kg boy with Lowe syndrome visited Seoul National University Dental Hospital for gingival swelling. The patient had multiple caries requiring dental treatment. Because of his past history of malignant hyperthermia during inhalation induction, anesthesia was induced and maintained with total intravenous anesthesia (TIVA) after medical consultation. Dental restorative treatments were successfully performed and no complications were observed during and after the procedure. Safe and effective dental management of the patients with Lowe syndrome could be performed with the help of general anesthesia and careful monitoring.

DENTAL TREATMENT FOR A PATIENT WITH WOLF-HIRSCHHORN SYNDROME UNDER GENERAL ANESTHESIA: CASE REPORT (울프-허쉬호른 증후군(Wolf-Hirschhorn syndrome) 환자의 전신마취 하 치과치료 : 증례보고)

  • Ryu, GiYoun;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.65-69
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    • 2019
  • Wolf-Hirschhorn syndrome(WHS) is a congenital disorder caused by deletions of the short arm of chromosome 4. The most common characteristics are mental and growth retardation, dietary disorder and craniofacial features with a characteristic 'Greek warrior helmet' appearance. The dental characteristic of WHS includes delayed development, tooth agenesis, clefts, microdontia, taurodontism, and severely worn dentition. The purpose of this case report is to describe the dental treatment of a patient with WHS. 3-year-old boy with WHS visited the Seoul National University Dental Hospital for dental treatment. He had difficulty with nasotracheal intubation because of craniofacial anomalies and also had poor oral hygiene due to a limitation of mouth opening and dietary disorder. Due to his airway problem, behavior management and severity of dental conditions, dental treatment was performed under general anesthesia. This case suggests general anesthesia can be chosen with WolfHirschhorn syndrome patients to safely care for their dental problems.

Prosthetic treatment for patient with congenital bilateral cleft lip and palate to close oro-nasal communication using maxillary double crown and clasp retained removable denture (선천성 양측성 구순구개열 환자의 구비강 연결 폐쇄를 위한 상악 이중관과 고리 유지형 국소의치를 이용한 수복 증례)

  • Doh, Seok-Joo;Cho, Jin-Hyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.1
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    • pp.18-23
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    • 2019
  • Patients with cleft lip and palate have several problems such as oro-nasal communication, dental cross-bite caused by the insufficient growth of maxilla, poor pronunciation and esthetic problem. Removable denture with maxillary double crown near cleft palate and with clasp in the posterior teeth was used to solve the problems of the patient with cleft lip and plate. Double crowns make up for the insufficient mucosal support caused by the mucosa and alveolar bone loss in cleft lip and palate. Double crowns also allow easy repair of denture in case of abutment teeth extraction. In this case, 55-year-old female patient had bilateral cleft lip and palate and few remaining teeth on anterior maxilla. Prosthetic treatment was done for patient with bilateral cleft lip and palate to close oro-nasal communication using maxillary double crown and clasp retained removable denture. As a result, oro-nasal communication was effectively closed and the cross-bite was easily corrected by double crown and clasp retained denture. In addition, pronunciation and appearance were also improved.