• Title/Summary/Keyword: Pediatric trauma

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The Clinical Study for Empyema: 176 Cases (농흉의 임상적 고찰[176예])

  • Oh, Bong-Seok;Choi, Jong-Beom;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.475-485
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    • 1980
  • For the past 5 year 6 months from January 1975 to June 1980, 176 patients with empyema have been treated in Chonnam University Hospital. They were 134 males and 42 females ranging from ] 8 days to 69 years of age. [mean age: 26.1 years] The duration of illness prior to treatment was relatively shorter in pediatric group than in adult group, that is, the duration of less than 1 month was 89.5% in pediatric group and 38.0% in adult group. In bacteria study there were Staphylococcus 26.1%, Streptococcus 17.6%, E. coil 10.8%, Pseudomonas 10.8%, Diplococcus pneumoniae 5.7% and Candidia. And 4 children and 3 adults had infections of two species of bacteria. The underlying pathologic lesions were pyogenic pneumonia 34.7%, tuberculosis 29.5%, paragonimiasis 15.3%, trauma 9.7% and postoperative state. The over-all mortality rate was 1.7% [3 patients]. The causes of death were sepsis In 1 child and sepsis secondary to esophageal fistula in 2 adults. Adequate drainage and obliteration of the pleural space seems to be the most important aspect of treatment and can frequently be achieved by initial tube drainage in acute empyema, especially in the pediatric group. The chronic thick walled or loculated cavities required open window therapy, decortication, resection therapy and sterilization. Modified Eloesser`s operation and 0.3-0.5% potadine irrigation brought good result in the patients who had general weakness, marked pulmonary parenchymal destruction due to pyothorax, and pyothorax with severe bronchopleural fistula.

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TREATMENT OF MISSING CENTRAL INCISORS USING SPACE REGAINING AND MARYLAND BRIDGE : CASE REPORT (상실된 영구 중절치의 교정적 치료와 심미적 수복 치험례)

  • Jun, Sang-Eun;Kim, Yong-Kee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.21 no.2
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    • pp.611-616
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    • 1994
  • A major cause of missing permanent incisors is congenital abscence and extraction because of trauma and pathologic condition. The request for restoration of missing or spaced anterior teeth is common in dental practice. Problems, such as the tilting, drifting, and rotation of teeth adjacent to the space, complicate the restoration of apperance, and a normally simple restorative dental procedure may become difficult. There are two primary treatment alternatives to improving a dentition's irregular and spaced apperance-closing the space by orthodontic means or providing a prosthesis to disguise the space. The treatment choice depends on many variables, but, as a general rule, patients with a normal overbite, overjet, and buccal relationship are better treated by maintaining the sapce and providing a prosthesis, either fixed or removable. This case report presents two cases : Traumatic loss of maxillary right and left central incisors, Extraction of malformed mandibular right central inciosr. The loss of central incisor space was regained by the fixed-removable and fixed orthodontic appliance, and then Maryland bridge was cemented.

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Early Spontaneous Recanalization of Sigmoid Sinus Thrombosis Following a Closed Head Injury in a Pediatric Patient : A Case Report and Review of Literature

  • Yun, Jung-Ho;Ko, Jung Ho;Lee, Mee Jeong
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.150-154
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    • 2015
  • Cerebral venous sinus thrombosis (CVST) following a closed head injury in pediatric patients is a rare condition, and an early spontaneous recanalization of this condition is extremely rare. A 10-year-old boy was admitted with a mild, intermittent headache and nausea five days after a bicycle accident. The brain computed tomography showed an epidural hematoma at the right occipital area with pneumocephalus due to a fracture of the occipital skull bone. The brain magnetic resonance imaging and the magnetic resonance venography demonstrated a flow signal loss from the right sigmoid sinus to the right jugular vein. The diagnosis was sigmoid sinus thrombosis, so close observations were selected as a treatment for the patient because of his gradually improving symptoms; however, he complained of vomiting 14 days the after conservative treatment. The patient was readmitted for a further examination of his symptoms. The laboratory and the gastroenterological examinations were normal. Due to concern regarding the worsening of the sigmoid sinus thrombosis, the brain magnetic resonance venography was rechecked and it revealed the recanalization of the venous flow in the sigmoid sinus and in the jugular vein.

The Clinical Characteristics of Amusement-park-related Injuries (경기도 지역의 일개 대형 놀이공원에서 발생한 환자를 통한 대형 놀이공원에서의 외상성 손상의 양상)

  • Lee, Jae Hyuk;Sim, Min Seob;Song, Hyoung Gon
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.103-107
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    • 2009
  • Purpose: There are no reports on amusement-park-related injuries in Korea. Thus, the objective of this study was to describe traumatic injury patterns that occurring in an amusement park. Methods: The medical records of an infirmary were retrospectively reviewed. From January 1, 2008, to December 31 2008, patients who were transferred to the nearest emergency departments of hospitals for the purpose of further test and treatment were enrolled. Demographics, injury types and involved parts of the body were analyzed. Results: A total of 3,608 patients visited an infirmary for traumatic injury and about two-thirds had soft issue injuries. Of those, 191 patients (5.3%) were transferred to the emergency department of a hospital. Of the patients who were transferred to a hospital, laceration and contusion were the responsible injuries for about half. Laceration was the most common injury in pediatric patients, and a sprain or a strain was the most common in adult patients. The most commonly injured parts of the body were the extremities in adult patients. However, in pediatric patients, injuries of the head, face and neck were similar to injuries of the extremities. Conclusion: Soft tissue injury was the most common amusement-park-related injury. Laceration was the most common reason to transfer a patient to a hospital. There were differences in injury type and injured part of the body between adult and pediatric patients.

Phrenic Nerve Paralysis after Pediatric Cardiovascular Surgery (소아 심혈관수술 후의 횡격막마비)

  • 윤태진
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1542-1549
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    • 1992
  • From March 1986 to August 1992, 18 patients underwent diaphragmatic plication for the diaphragmatic paralyses complicating various pediatric cardiac procedures. Age at operation ranged from 16 day to 84 months with mean age of 11.8 months. In order of decreasing incidence, the primary cardiac procedures included modified Blalock-Taussig shunt [ 5 ], Arterial switch operation [ 4 ], modified Fontan operation [ 2 ], and others [ 7 ]. The suspicious causes of phrenic nerve injury included overzealous pericardial resection [ 7 ], direct trauma during the procedure [ 6 ], dissection of fibrous adhesion around the phrenic nerve [ 3 ] and unknown etiology [ 2 ]. The involved sides of diaphragm were right in 10, left in 7 and bilateral in one. The diagnosis was suspected by the elevation of hem-idiaphragm on chest x-ray and confirmed by fluoroscopy. The interval between primary operation and plication ranged from the day of operation to 38 postoperative days [mean : 14 days]. The method of plication were "Central pleating technique" described by Schwartz in 16 and other techniques in 2. Five patients expired after plication and the cause of death were not thought to be correlated directly with the plication itself. In the remaining 13 survivors, extubation or cessation of positive ventilation could be done between the periods of the day of plication and 14th postoperative days [mean; 3.8day]. We have made the following conclusions : 1] Phrenic nerve paralyses are relatively common complication after pediatric cardiac procedures and the causes of phrenic nerve injury are mostly preventable; 2] Phrenic nerve palsy is associated with corisiderable morbidity; 3] diaphragmatic plication is safe, reliable and can be applicable in patients who are younger age and require prolonged positive pressure ventilation.ntilation.

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Reasons for primary teeth extraction in children : Retrospective study (유치 발거 원인에 대한 후향적 연구)

  • Kim, Byoung-hwa;Lee, Je-woo;Ra, Ji-young
    • The Journal of the Korean dental association
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    • v.58 no.3
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    • pp.169-179
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    • 2020
  • The purpose of this study was to investigate the principal reasons for primary teeth extractions and the tooth type extracted in children. 1159 patients were selected in this study. Dental records and radiographs were reviewed and age, gender, medical history, type of tooth extracted and the reasons for extraction were collected. The data were statistically analyzed using Chi-square test. Total 2078 primary teeth were extracted. Central incisors(34.1%) were most frequently extracted. Extractions due to physiological mobility(77.5%) were the most frequent followed by caries(13.8%), orthodontic(3.9%), trauma(1.7%). Reason for the extraction was different according to age (p = 0.000), but there was no difference according to gender (p = 0.109). While extractions due to physiological mobility predominated overall, reason for extraction was different according to the tooth type. There was no previous treatment in 54.6% of primary teeth extracted due to caries. Excluded physiological mobility, caries are the most common reason for extraction of primary teeth. The importance of preventive care should be emphasized in order to preserve primary teeth and improve children's oral health.

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Radiological Manifestations of Childhood Fractures (소아 골절의 영상의학적 소견)

  • Jae-Yeon Hwang
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.806-831
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    • 2020
  • Musculoskeletal injury is the most common cause of children visiting the department of emergency medicine. Since the bone is still developing, pediatric patients have characteristic radiological manifestations, including plastic deformation, greenstick fractures, and buckle (or torus) fractures. Furthermore, growth arrest can occur in those with physeal fractures. Various mechanisms are responsible for pediatric musculoskeletal injury since children have different ranges of activities, depending on their age, such as birth injury and fall and traffic accidents. Some fractures have characteristic locations and radiological manifestations. In this review, we will discuss various radiological manifestations of fractures involving both upper and lower limbs in pediatric patients.

Esthetic Restoration of Complicated Crown-Root Fractures Utilizing Orthodontic Extrusion (복합 치관-치근 파절의 교정적 정출술을 이용한 심미적 수복)

  • Kim, Minji;Kim, Jinyoung;Kim, Suhyun;Lim, Sumin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.1
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    • pp.60-69
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    • 2016
  • Complicated crown-root fracture of permanent incisors cause esthetic, functional, and psychological problems to patients. Therefore, treatment is important and multidisciplinary treatment is required. This case report describes the clinical procedures involved in the treatment of trauma-induced complicated crown-root fractures in the maxillary incisor of two young patients. Conventional root canal treatment and apexification were performed in each patient. To expose the fracture margins to the supragingival level and to reestablish the biologic width, orthodontic extrusions with fixed appliances were performed followed by a retention period. During the retention period, fiber-optic posts and cores were built up and provisional crowns were placed. Finally, ceramic crowns manufactured using a computer-aided design/computer-aided manufacturing (CAD/CAM) system were placed. In both patients, the teeth presented satisfactory functional and esthetic outcomes without relapse. The periodontal tissues were healthy.

TREATMENT OF LINGUAL ULCERS CAUSED BY TONGUE THRUST WITH HYPOXIC-ISCHEMIC ENCEPHALOPATHY (저산소성 허혈성 뇌병변 환아에서 혀내밀기에 의해 발생된 혀 궤양의 치료: 증례 보고)

  • Oh, Mee-Hee;Kim, So-Jung;Choi, Sung-Chul;Kim, Kwang-Chul;Park, Jae-Hong
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.8 no.1
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    • pp.22-25
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    • 2012
  • Hypoxic ischemic encephalopathy(HIE) is a condition that occurs when the entire brain is deprived of an adequate oxygen supply and associated in most cases with oxygen deprivation in the neonate due to birth asphyxia. Children with HIE develop problems such as cerebral palsy, mental retardation, learning difficulties, and other disabilities. We hereby report the case of treating a child patient with HIE whose chief complaint of severe lingual ulceration. A 12-month-old boy referred to our hospital to treat ulcers of ventral surface of tongue. He has been suffering from lingual ulceration due to persistent tongue thrusting. He has bitten his own tongue involuntary. The ulceration was apparently seemed to be not healed because of the constant irritation by lower incisors. So we designed tongue protector to prevent lingual ulcers. The appliance was proved to be effective to reduce tongue trauma by lower incisors and periodic follow-up is needed.

A CASE REPORT ON INTENTIONAL REPLANTATION OF MAXILLARY FIRST BICUSPID (Intentional Replantation에 의한 상악 제 1 소구치 치료의 증례보고)

  • Chung, Woo-Jin;Kim, Jong-Bum;Lee, Sang-Hoon;Hahn, Sae-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.3
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    • pp.556-561
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    • 1997
  • Intentional replantation of the posterior teeth has been performed as a last resort except extraction when it is impossible to perform the conventional endodontic or surgical endodontic treatment. Many studies have done with the prognosis, and root resorption, of which the responsibility might have been injury of periodontal ligament and remaining periodontal lesion, proved to be major cause of failure. Intentional replantation, however, can exclude anatomic difficulty, risk of nerve injury, and maxillary sinus trauma that surgical access can raise, especially in posterior teeth, and it is reported that success rate is not less than surgical endodontics, independent of replantation of traumatically avulsed teeth. The success of intentional replantation can be evaluated with, clinically, reduction of pocket depth, pain and mobility(physical mobility), and, radiographically, hard tissue formation, reduction of periapical radiolucency. In this case report, for the maxillary left first bicuspid with dens evaginatus that had periapical lesion, painfulness, mobility and showed no reduction of mobility after even extirpation and a number of irrigation, extraction followed by extraoral root filling with calcium hydroxide and replantation was performed. Based on many studies, it is concluded that hard tissue formation capacity of calcium hydroxide, preceded extirpation before extraction, and careful extraction without injuring periodontal ligament affected successful results of this case.

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