• Title/Summary/Keyword: Congenital defect

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The First Successful Heart-Lung Transplantation in Korea (심장-폐이식 1례보고)

  • 박국양;김주이;박철현;김상익;김정철;현성열;심현자;정미진;권진형
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.610-614
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    • 1998
  • The first heart-lung transplantation in Korea was successfully performed. The recipient was a 11 year old girl with pulmonary atresia with intact ventricular septum. She had been catheterized at the ages of 4 months, 3 years, 7 years and 10 years, which revealed that neither Fontan nor biventricular repair was feasible. The donor was a traffic accident victim, a 9 year-old boy with the same blood type. The donor was pronounced dead according to the guidelines of the Korean Medical Association's Brain Death Committee. The operation was performed on April 20, 1997. The native heart-lung block was explanted segmentally and donor one was placed above the phrenic nerve using the Arizona technique. After the tracheal anastomosis with single continuous 4-0 prolene, both vena cavae were anastomosed, followed by aortic anastomosis. The graft ischemic time was 145 minutes. The postoperative course was complicated by fever and tracheal stenosis at the anastomosis site. The fever was controlled by anti-tuberculous medications and the tracheal stenosis was relieved by stent(Palmaz 8 mm, 30 mm in length) placement on POD #71. The patient is doing well and is very active in her 7th postoperative month.

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The First Neurosurgical Analysis of 8 Korean Children with Sotos Syndrome

  • Lim, Jae-Joon;Yoon, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.44 no.4
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    • pp.240-244
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    • 2008
  • Objective : Sotos Syndrome is characterized by macrocephaly, overgrowth, and developmental delay, and more than 300 patients have been reported worldwide to date. The authors reviewed the clinical characteristics of 8 patients with Sotos Syndrome in Korea for a new understanding and treatment strategies. Methods : The medical records of a total of eight Korean children with Sotos Syndrome were reviewed. All patients underwent developmental checkup, lumbar punctures for measurement of intracranial pressure (ICP), brain and spine magnetic resonance imaging and computerized tomography. Results : All 8 patients showed macrocephaly and the characteristic craniofacial features of Sotos Syndrome. Other clinical characteristics shown were overgrowth (7/8), developmental delay (7/8), congenital heart defect (3/8), flat foot (8/8), scoliosis (4/8), spina bifida (8/8), hydrocephalus (4/8), cavum vergae (3/8), and increased subdural fluid collection (5/8). Mean ICP measured via lumbar puncture was $27.35{\pm}6.25\;cm$ $H_2O$ (range 20 to 36 cm $H_2O$). Two patients received ventriculo-peritoneal shunt, and 1 patient underwent subduro-peritoneal shunt with improvement. Spinal orthosis was applied to 4/5 patients with scoliosis and 4/8 children with flat foot were provided with foot orthosis. Conclusion : In this first Korean study of 8 Sotos Syndrome patients we demonstrated the presence of spina bifida and increased ICP, which had not been previously described. The authors therefore suggest that all patients with Sotos Syndrome should undergo examination for the presence of spina bifida, and that shunt procedures would improve development and alleviate clinical symptoms.

Intervention with Balloon Valvuloplasty followed by Patent Ductus Arteriosus Stent in a Patient with Pulmonary Atresia with Intact Ventricular Septum (풍선판막성형술과 동맥관 스텐트를 이용하여 치료한 심실중격결손을 동반하지 않은 폐동맥 폐쇄 1례)

  • Lim, Han Hyuk;Kim, Young Deuk;Lee, Jae Hwan;Chang, Mea Young;Kil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1256-1256
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    • 2005
  • Pulmonary atresia with intact ventricular septum (PAIVS) is rare, less than 1% of congenital heart disease. It needs a therapeutic approach according to its individual morphologic feature. Surgical treatment of valvotomy and modified Blalock-Taussig shunt or non-surgical interventional catheter balloon valvuloplasty can be used for mild to moderate hypoplasia of right ventricle. Fontan operation can be considered for less optimum morphological substrate of two ventricular repair. A 3-day-old male neonate was admitted with cyanosis and cardiac murmur. On echocardiogram, he had membranous pulmonary atresia with intact ventricular septum, normal sized tripartite right ventricle, large atrial septal defect with right-to-left shunt, small sized patent ductus arteriosus, and moderate tricuspid regurgitation. He was treated with intravenous continuous infusion of prostaglandin $E_1$ ($PGE_1$) at once. On the third day of hospitalization, Balloon valvuloplasty was performed. After insertion of patent ductus arteriosus stent on the tenth day, $PGE_1$ infusion was discontinued. On the fifteenth day, he was discharged. Now, he is 9 months old and has nearly normal cardiac structure and function with 97% of percutaneous oxygen saturation.

The first Korean case of poland-Mobius syndrome associated with dextrocardia (Poland-Mobius syndrome 신생아 1례)

  • Jung, Jiyoung;Kim, Han Gyu;Ahn, Hae-Mi;Cho, Su Jin;Park, Eun Ae
    • Clinical and Experimental Pediatrics
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    • v.52 no.12
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    • pp.1388-1391
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    • 2009
  • Poland syndrome is characterized by unilateral absence or hypoplasia of the pectoralis muscle and variable degree of ipsilateral hand anomalies. Mobius syndrome is a congenital neurological disorder characterized by complete or partial facial paralysis. Although the pathogeneses of these diseases are not well-characterized, diminished blood flow to the affected side is thought to play a role. A male infant weighing 2.670 g was born at 38+3 weeks of gestation with left facial paralysis, left chest wall defect with dextrocardia, and symbrachydactyly between the second and third fingers. The combination of Poland-Mobius syndrome is rare, and only 2 cases associated with dextrocardia have been reported worldwide. Here, we report the first case of Poland-Mobius syndrome associated with dextrocardia in Korea.

Developmental Anomalies of Central Nervous System in Human

  • Chi, Je G.
    • Toxicological Research
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    • v.17
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    • pp.11-16
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    • 2001
  • The development of the central nervous system is a continuous process during the embryonic and fetal periods. For a better understanding of congenital anomalies of central nervous system, three major events of normal development, i.e., neurulation (3 to 4 weeks), brain vesicle formation (4 to 7 weeks) and mantle formation (over 8 weeks) should be kept in mind. The first category of anomalies is neural tube defect. Neural tube defects encompass all the anomalies arise in completion of neurulation. The second category of central nervous system anomalies is disorders of brain vesicle formation. This is anomaly that applies for "the face predicts the brain". Holoprosencephaly covers a spectrum of anomalies of intracranial and midfacial development which result from incomplete development and septation of midline structures within the forebrain or prosencephalon. The last category of central nervous system malformation is disorders involving the process of mantle formation. In the human, neurons are generated in two bursts, the first from 8 to 10 weeks and next from 12 to 14 weeks. By 16 weeks, most of the neurons have been generated and have started their migration into the cortex. Mechanism of migration disorders are multifactorial. Abnormal migration into the cortex, abnormal neurons, faulty neural growth within the cortex, unstable pial-glial border, degeneration of neurons, neural death by exogenous factors are some of the proposed mechanism. Agyria-pachygyria are characterized by a four-layerd cortex. Polymicrogyria is gyri that are too numerous and too small, and is morphologically heterogeneous. Cortical dysplasia is characterized by the presence Q[ abnormal neurons and glia arranged abnormally in focal areas of the cerebral cortex. Neuroglial malformative lesions associated with medically intractable epilepsy are hamartia or hamartoma, focal cortical dysplasia and microdysgenesis.ysgenesis.

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Use of an Amplatzer Vascular Plug to occlude a tubular type of patent ductus arteriosus (원통형 모양 동맥관의 경피적 폐쇄술에서의 Amplatzer Vascular Plug 의 사용)

  • Choi, Eun-Young;Jang, So-Ick;Kim, Soo-Jin
    • Clinical and Experimental Pediatrics
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    • v.52 no.9
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    • pp.1035-1037
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    • 2009
  • Patent ductus arteriosus (PDA) is a common congenital heart defect. All PDAs, regardless of size or degree of symptoms, require occlusion. Transcatheter PDA occlusion features fewer complications than trans-thoracic closure. It is also more cost-effective and has an excellent occlusion rate. Therefore, transcatheter PDA occlusion is accepted as the standard treatment option for PDA. However, tubular-type PDAs are difficult to close with ordinary detachable coils or the Amplatzer Duct Occluder; thus, these lesions remain a challenge for transcatheter closure. We attempted to occlude a tubular-type PDA by using an oversized Amplatzer Vascular Plug, which allowed intraluminal packing of the ductus. By using this treatment method, PDA occlusion was achieved safely with an excellent final outcome. We suggest that this approach may be a good option for transcatheter closure of a tubular-type PDA.

Understanding of Cleft Lip Managment by Review of Treatment History (역사적 고찰을 통한 구순열 치료의 이해)

  • Kim, Hui-Young;Myoung, Hoon;Lee, Jong-Ho;Lee, Suk-Keun;Choi, Jin-Young;Kim, Soung-Min
    • Korean Journal of Cleft Lip And Palate
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    • v.16 no.1
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    • pp.37-49
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    • 2013
  • Cleft lip is a common congenital facial deformity which might cause speech, hearing, appearance, and psychological disorder. For the purpose of appropriate management for the cleft lip patients according to their individual situations, reviews of the historical evolution for the cleft lip treatment were summarized. More than 15 English written articles with 4 related historical books were reviewed, and the chronology of the cleft lip management from ancient to recent twenty first century, via middle ages and Renaissance, were summarized. Multifactorial causes of cleft lip, before the modern understanding of embryological background of it, most management of cleft lip has been explained under the basis of religions and/or superstitions. As the anatomic and embryologic knowledges were known and revealed, various misconceptions were corrected continously, and the simple closure of the lip defect was also evoluted to the applications of plastic concept. Recently, cosmetic outcomes with functional results, such as speech, hearing, psychological status, have been considered importantly, under the multidiciplinary care system. For the better understanding of cleft lip management as a routine esthtetic and funtional reconstructive procedure, the various historical treatment trends were reviewed and summarized as time goes on. This review presentation will discuss the appropriate management for cleft lip patients.

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Clinical Experience with Nasolabial Cysts Using the Sublabial Approach (구강내 접근법을 이용한 비순낭종의 치료 경험)

  • Kwon, Joon-Sung;Choi, Hwan-Jun;Choi, Chang-Yong;Park, Jae-Hong;Park, Nae-Kyeong;Kim, Sook
    • Archives of Plastic Surgery
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    • v.38 no.3
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    • pp.251-256
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    • 2011
  • Purpose: A nasolabial cyst is a rare non-odontogenic, soft-tissue, developmental cyst arising anywhere on the face inferior to the nasoalar region. It is thought to arise from either epithelial remnants trapped along the lines of fusion during the development of face or the remnants of the developing nasolacrimal duct. This study examines various features of nasolabial cysts with bony involvement to provide a basis for correct diagnosis and treatment. Methods: Eight cases of nasolabial cyst treated in Soonchunhyang Hospital between March 2002 and July 2010 were examined in terms of their clinical features and radiological and histological findings. Seven patients underwent surgical excision of the cyst via an intraoral, sublabial approach. One underwent incision and drainage. Results: Our eight patients were seven women and one man. The most frequent symptoms and signs were facial deformity and swelling of the nasolabial fold. Computed tomography (CT) showed a well-circumscribed cystic mass lateral to the pyriform aperture. Seven cases had erosive lesions on CT, and the intraoperative findings were consistent with a nasolabial cyst with a bony defect. Typical histopathological findings showed that these cysts were most frequently lined with respiratory epithelium with ciliated columnar cells and cuboid cells. No patient developed complications or recurrences. Conclusion: A nasolabial cyst is often unrecognized or confused with other intranasal masses, including fissural and odontogenic cysts, midface infections, or swelling in the nasolabial area. Therefore, a careful clinical and radiological evaluation should be preformed when considering the differential diagnosis. We present eight patients with nasolabial cysts treated via a gingivobuccal approach with excellent functional and cosmetic results.

CLINICAL MANAGEMENT OF ECTODERMAL DYSPLASIA : A CASE REPORT (외배엽 이형성증 환자의 임상적 치험례)

  • Oh, So-Hee;Kwon, Soon-Won;Kim, Jong-Soo;Kim, Yong-Kee;Lim, Hun-Song
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.2
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    • pp.222-228
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    • 2000
  • Ectodermal dysplasia is a hereditary disease characterized by a congenital dysplasia of one or more ectodermal structures and their accessory appendages. At least 120 subtypes of ectodermal dysplasia have been reported. The disease is usually transmitted as an X-linked recessive trait in which the gene is carried by the female and manifested in the male. Hypohidrotic ectodermal dysplasia is manifested as a triad of defects that include hypohidrosis, hypotrichosis and hypodontia. The characteristic facial features consist of asteatosis, onchodysplasia, sparse and fine blond hair, prominent forehead, a depressed nasal bridge, thick everted lips. The patient may suffer from dry skin, hyperthermia and unexplained high fever as a result of the deficiency of sweat glands. This case report presents detailed procedures of rehabilitating functional and esthetic defect of a 6-year-old boy with hypohidrotic ectodermal dysplasia along with the review of relevant literatures.

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Neural Tube Defects with Abdominal Wall Defects in Sibling Dogs (복벽결손을 동반한 동복자견의 신경관결손)

  • Cho, Sung-Jin;Kim, Ok-Jin
    • Journal of Veterinary Clinics
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    • v.26 no.5
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    • pp.467-471
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    • 2009
  • This report describes Neural Tube Defects (NTDs) with Abdominal Wall Defects (AWDs) on the sibling of Yorkshire terriers. The NTDs and AWDs are rare serious congenital defects. The NTDs are neurulation abnormality that results from to failed transformation of the neurual tube by the incomplete closure of the embryonic neural plate. These dysraphic states range form mild to severe according to developmental malformation that include fusion defects of skull (crania bifida; CB) and fusion defects of vertebrae (spina bifida; SB). The AWDs are genetic defects that results from to failed formation of abdominal wall and cavity. These dysraphic states are omphalocele and gastroschisis. The 12-month dam was delivered by caesarian section and 4 littermate had obvious malformations. One male dead stillbirth fetus (L1) was revealed the extruded abdominal viscera, omphalocele. One female fetus (L2) was died within 1 hour after birth with defects of abdominal muscle upper umbilicus, gastroschisis. 3rd fetus (L3) was died within 36 hours after parturition and revealed a copious dermal and vertebral defects on the midline thorax, upper SB asperta. 4th fetus (L4) is still growing well now at 6 months but at the 2 week age, appears hairy nevus on the frontal cranium and dorsal thoracic portion. The radiograph of L1 and L2 are shown decrease bony density of calvarium and L3 was shown defect of spinose processes of the T9-T13. On our knowledge, this is first report of the SB and CB in Yorkshire terrier. And also sibling of NTDs with AWDs that has not previously been reported in the dog.