• Title/Summary/Keyword: defect severity

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Surgical indication analysis according to bony defect size in pediatric orbital wall fractures

  • Kim, Seung Hyun;Choi, Jun Ho;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.21 no.5
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    • pp.276-282
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    • 2020
  • Background: Orbital fractures are the most common pediatric facial fractures. Treatment is conservative due to the anatomical differences that make children more resilient to severe displacement or orbital volume change than adults. Although rarely, extensive fractures may result in enophthalmos, causing cosmetic problems. We aimed to establish criteria for extensive fractures that may result in enophthalmos. Methods: We retrospectively reviewed the charts of patients aged 0-15 years diagnosed with orbital fractures in our hospital from January 2010 to February 2019. Computed tomography images were used to classify the fractures into linear, trapdoor, and open-door types, and to estimate the defect size. Data on enophthalmos severity (Hertel exophthalmometry results) and fracture pattern and size at the time of injury were obtained from patients who did not undergo surgery during the follow-up and were used to identify the surgical indications for pediatric orbital fractures. Results: A total of 305 pediatric patients with pure orbital fractures were included-257 males (84.3%), 48 females (15.7%); mean age, 12.01±2.99 years. The defect size (p=0.002) and fracture type (p=0.017) were identified as the variables affecting the enophthalmometric difference between the eyes of non-operated patients. In the linear regression analysis, the variable affecting the fracture size was open-door type fracture (p<0.001). Pearson's correlation analysis demonstrated a positive correlation between the enophthalmometric difference and the bony defect size (p=0.003). Using receiver operating characteristic curve analysis, a cutoff value of 1.81 ㎠ was obtained (sensitivity, 0.543; specificity, 0.724; p=0.002). Conclusion: The incidence of enophthalmos in pediatric pure orbital fractures was found to increase with fracture size, with an even higher incidence when open-door type fracture was a cofactor. In clinical settings, pediatric orbital fractures larger than 1.81 ㎠ may be considered as extensive fractures that can result in enophthalmos and consequent cosmetic problems.

Closure of Ventricular Septal Defect under 10Kg in Body Weight (10Kg 이하의 소아에서 시행한 심실중격 결손증수술에 대한 임상적 고찰)

  • 김정철;구본일;오상준;이홍섭;김창호;신혜숙;박용원;박동철;변정욱
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1191-1196
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    • 1996
  • Recently, if there is pulmonary hypertension in ventricular septal defect, early operation without pulmonary artery banding is recommended even though patient is under 1 year in age or has low body weight. We also had been performing operations under the above mentioned policy. From October 1986 to December 1995, eighty eight cases of ventricular septal defect under 10Kg in body weight were operated upon by open cardiac surgery. Mortality was compared by age, body weight and degree of pulmonary vascular hypertension. Total mortality was 10cases(11.4%); under 6months, the mortality was 5 in 14 cases(35.8%), from 6 months to 1year, 4 in 43 cases(9.3%) and over 1 year, one in 31 cases(3.2%), while there was no significant difference in mortality compared by degree of pulmonary vascular hypertension. And mortality under 6months in age was so high regardless of severity of pulmonary hypertension. After this exprience, too early operation,. especially under 6 months, should be considered very prudently, unless there were life threatning heart failure, impending irreversible pulmonary vascular bed change or failure to thrive.

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Compromised extraction sockets: a new classification and prevalence involving both soft and hard tissue loss

  • Kim, Jung-Ju;Amara, Heithem Ben;Chung, Inna;Koo, Ki-Tae
    • Journal of Periodontal and Implant Science
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    • v.51 no.2
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    • pp.100-113
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    • 2021
  • Purpose: Previous studies have solely focused on fresh extraction sockets, whereas in clinical settings, alveolar sockets are commonly associated with chronic inflammation. Because the extent of tissue destruction varies depending on the origin and the severity of inflammation, infected alveolar sockets may display various configurations of their remaining soft and hard tissues following tooth extraction. The aim of this study was to classify infected alveolar sockets and to provide the appropriate treatment approaches. Methods: A proposed classification of extraction sockets with chronic inflammation was developed based upon the morphology of the bone defect and soft tissue at the time of tooth extraction. The prevalence of each type of the suggested classification was determined retrospectively in a cohort of patients who underwent, between 2011 and 2015, immediate bone grafting procedures (ridge preservation/augmentation) after tooth extractions at Seoul National University Dental Hospital. Results: The extraction sockets were classified into 5 types: type I, type II, type III, type IV (A & B), and type V. In this system, the severity of bone and soft tissue breakdown increases from type I to type V, while the reconstruction potential and treatment predictability decrease according to the same sequence of socket types. The retrospective screening of the included extraction sites revealed that most of the sockets assigned to ridge preservation displayed features of type IV (86.87%). Conclusions: The present article classified different types of commonly observed infected sockets based on diverse levels of ridge destruction. Type IV sockets, featuring an advanced breakdown of alveolar bone, appear to be more frequent than the other socket types.

Is vaginal reflux associated with urinary tract infection in female children under the age of 36 months?

  • Kim, Yu Bin;Tang, Chih Lung;Koo, Ja Wook
    • Clinical and Experimental Pediatrics
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    • v.61 no.1
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    • pp.17-23
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    • 2018
  • Purpose: To determine the relationship between vaginal reflux (VR) and urinary tract infection (UTI) in female children aged <36 months. Methods: A single center retrospective study was performed for 191 girls aged <36 months, with a diagnosis of febrile UTI, who underwent a voiding cystourethrography (VCUG) for assessment of vesicoureteral reflux (VUR) at Sanggye Paik Hospital. Fifty-one girls, who underwent VCUG for assessment of congenital hydronephrosis or renal pelvis dilatation, without a UTI, formed the control group. The correlation between the presence and grade of VR and UTI was evaluated. Results: The prevalence rate of VR was higher in the UTI (42.9%) than control (13.7%) group (P<0.05), with a higher VR severity grade in the UTI (mean, 0.64) than control (mean, 0.18) group (P<0.05). On subanalysis with age-matching (UTI group: n=126, age, $5.28{\pm}2.13months$; control group: n=22, age, $4.79{\pm}2.40months$; P=0.33), both VR prevalence (43.65% vs. 18.18%, P<0.05) and grade (0.65 vs. 0.22, P<0.05) remained higher in the UTI than control group. Presence and higher grade of VR were associated with UTI recurrence (P<0.05). VR was correlated to urosepsis (P<0.05). The renal defect rate of patients with VR (VR [+]/VUR [+]) was not different from that of patients without VR (74% vs. 52%, P=0.143) in the VUR group; however, it was higher than that of VR (+)/VUR (-) patients (74% vs. 32%, P=0.001). If a child with VR (+)/VUR (+) is exposed to a UTI, the risk of renal defect increases. Conclusion: Occurrence of VR is associated with UTI recurrence and urosepsis in pediatric female patients.

Clinical implications of DMSA Scan in Childhood Acute Pyelonephritis

  • Huh, Sun-Mi;Park, Bo-Kyoung;Kang, Hyun-Mi;Rhim, Jung-Woo;Suh, Jin-Soon;Lee, Kyung-Yil
    • Childhood Kidney Diseases
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    • v.21 no.2
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    • pp.107-113
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    • 2017
  • Purpose: This study aimed to evaluate the relationships between 99mTecnicium-dimercaptosuccinic acid (DMSA) scan findings and clinical parameters including age and fever duration. Methods: The positive rates for abnormal DMSA scans were analyzed according to the age of patients, fever duration prior to admission, and total fever duration. DMSA scan findings were divided into 3 categories: single defect, multifocal defects, and discrepant defects. We evaluated the detection rates of vesicoureteral reflux according to DMSA scan lesions. Results: Among a total 320 cases, 141 (44.1%) had abnormal DMSA scans. The infant group (0-1 year of age) had a shorter total fever duration, and a lower C-reactive protein (CRP) value and DMSA positive rate (39.8% vs. 60.6%, P=0.002) compared to children group (2-15 years of age). Patients with abnormal scans had a longer total fever duration and higher CRP compared to those with normal scans. The positivity rate of abnormal scans did not differ between the patients with a short fever duration prior to admission of ${\leq}2$ days and those with longer fever duration of ${\geq}3$ days. However, patients with longer total fever duration had a higher rate of abnormal DMSA scans (P=0.02). Among cases with a single defect, multifocal defects, and discrepant defects, vesicoureteral reflux was observed in 22.4%, 60% and 70.6% of cases, respectively (P=0.004). Conclusion: Although DMSA scan has limitations in early diagnosis, DMSA scan findings may aid in the prediction of the severity of systemic inflammation and detection of vesicoureteral reflux.

Monitoring of white striping and wooden breast cases and impacts on quality of breast meat collected from commercial broilers (Gallus gallus)

  • Malila, Yuwares;U-chupaj, Juthawut;Srimarut, Yanee;Chaiwiwattrakul, Premsak;Uengwetwanit, Tanaporn;Arayamethakorn, Sopacha;Punyapornwithaya, Veerasak;Sansamur, Chalutwan;Kirschke, Catherine P.;Huang, Liping;Tepaamorndech, Surapun;Petracci, Massimiliano;Rungrassamee, Wanilada;Visessanguan, Wonnop
    • Asian-Australasian Journal of Animal Sciences
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    • v.31 no.11
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    • pp.1807-1817
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    • 2018
  • Objective: This study aimed at investigating white striping (WS) and wooden breast (WB) cases in breast meat collected from commercial broilers. Methods: A total of 183 breast samples were collected from male Ross 308 broilers slaughtered at the age of 6 weeks (n = 100) and 7 weeks (n = 83). The breasts were subjected to meat defect inspection, meat quality determination and histology evaluation. Results: Of 183, 4 breasts from 6-week-old broilers were classified as non-defective while the others exhibited the WS lesion. Among the 6-week-old birds, the defective samples from the medium size birds (carcass weight ${\leq}2.5kg$) showed mild to moderate WS degree with no altered meat quality. Some of the breasts from the 6-week-old birds with carcass weight above 2.5 kg exhibited WB in accompanied with the WS condition. Besides of a reduction of protein content, increases in collagen matter and pH values in the defective samples (p<0.05), no other impaired quality indices were detected within this group. All 7-week-old broilers yielded carcasses weighing above 2.5 kg and showed abnormal characteristics with progressive severity. The breasts affected with severe WS and WB showed the greatest cook loss, hardness, springiness and chewiness (p<0.05). Development of WB induced significantly increased drip loss in the samples (p<0.05). Histology indicated necrotic events in the defective myofibers. Based on logistic regression, increasing percent breast weight by one unit enhanced the chance of WS and WB development with advanced severity by 50.9% and 61.0%, respectively. Delayed slaughter age from 6 to 7 weeks increased the likelihood of obtaining increased WS severity by 56.3%. Conclusion: Cases of WS and WB defects in Southeast Asia have been revealed. Despite few cases of the severe WS and WB, such abnormal conditions significantly impaired technological properties and nutritional quality of broiler breasts.

Hypodontia Pattern and Genetic Association in Cleft Lip and Palate Patients (구순구개열 환자의 치아 선천결손 유형과 관련 유전자에 관한 고찰)

  • Ahn, Hyo-Won;Baek, Seung-Hak
    • Korean Journal of Cleft Lip And Palate
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    • v.10 no.2
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    • pp.81-88
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    • 2007
  • Cleft lip and palate (CLP) is one of the most prevalent congenital craniofacial anomalies. It has a significantly greater incidence of dental abnormalities in number, size, shape, and eruption of the teeth. Knout-out mouse model can identify several genes which play an important role in tooth agenesis. Since disruption of these genes has been confirmed to result in tooth agenesis in humans, CLP associated with hypodontia may be the best models for isolated tooth agenesis. According to the studies of dental abnormalities in CLP, the severity of dental defect is known to be influenced by the CLP phenotype. The cumulative data obtained from mouse and human genetic studies indicated that MSX1, PAX9 and AXIN2 are considered as candidate genes in non-syndromic hypodontia, while Shh, Pitx2, Irf6, p63 and EDA pathway genes are involved in syndromic one. We expect that genetic approach of CLP can offer the basis for tooth regeneration and be a new target in hypodontia therapy.

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A study on surgical significance of angiographic pulmonary arterial size in tetralogy (활로 4 징증에서 술전 폐동맥 크기에 대한 연구)

  • Jo, Jae-Il;Kim, Jong-Hwan
    • Journal of Chest Surgery
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    • v.16 no.1
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    • pp.40-48
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    • 1983
  • Tetralogy of Fallot is characterized by the interventricular septal defect associated with obstruction of the right ventricular outflow. The importance of the latter anatomic malformation was clinically evaluated according to the angiographic measurements of the pulmonary arteries along with the pulmonary valve annulus. Seventy of a total 76 patients operated on during a whole year of 1981 were the patients for clinical evaluation. Fifteen patients died within 1 month after operation with the operative mortality of 21.4%. The young age and the severity of pulmonary arterial hypoplasia were ones among the surgical risk factors at a total corrective surgery of tetralogy. Preoperative angiographic measurements of the pulmonary arteries to speculate the expected postoperative ratio between the left ventricular and the right ventricular pressures were retrospectively calculated according to the formula. The predicted values of P RV/LV greater than 0.5 carried apparenliy higher complication and mortality rates than the group of P RV/LV less then 0.5. The selection of the candidates for either a total correction or the staged operation In tetralogy of Fallot can be evaluated on the preoperative angiographic measurements and the expected Improvements of the clinical results were discussed.

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Evaluation of echocardiographic markers in dogs with patent ductus arteriosus after ductal closure

  • Park, Jong-In;Suh, Sang-IL;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.56 no.4
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    • pp.209-213
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    • 2016
  • This study evaluated several known echocardiographic markers related to the assessment of severity in dogs with patent ductus arteriosus (PDA) after the closure of ductus arteriosus (DA). Forty-two dogs with patent ductus arteriosus were enrolled in this study. Evaluated echocardiographic markers were left atrial to aortic root ratio, left ventricular end-diastolic dimension to aortic root ratio, indexed left ventricular end-diastolic and end-systolic dimensions, end-diastolic and end systolic volume index, pulmonic flow to systemic flow (Qp/Qs) ratio, velocities of pulmonary regurgitant and systolic jets, pulmonary flow profiles and the presence of mitral regurgitation. Those markers were evaluated before, 1 day, and 30 days after the closure of DA. Statistically significant changes in some echocardiographic markers (i.e., Qp/Qs) were observed. Although several studies in human and dogs have evaluated the clinical outcome of PDA occlusion using several echocardiographic markers, this study has firstly evaluated all echocardiographic markers known to be useful for assessing the clinical outcome of PDA occlusion in human, and has demonstrated that those markers including the Qp/Qs and pulmonary flow profiles were useful in evaluating of clinical outcome of PDA in dogs and the reduction of LA and LV preload after ductal closure could dramatically reduce after successful ductal occlusion of PDA in dogs.

Development of sewer condition assessment and rehabilitation decision-making program(SCARD) (하수관거 평가 및 정비 우선순위 의사결정도구 개발)

  • Han, Sangjong;Hwang, Hwankook
    • Journal of Korean Society of Water and Wastewater
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    • v.29 no.1
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    • pp.123-131
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    • 2015
  • A CCTV inspection method has been widely used to assess sewer condition and performance, but Korea lacks a proper decision support system for prioritizing sewer repair and rehabilitation (R&R). The objective of this paper is to introduce the results that we have developed in the Sewer Condition Assessment and Rehabilitation Decision-making (SCARD) Program using MS-EXCEL. The SCARD-Program is based on a standardized defect score for sewer structural and hydraulic assessment. Priorities are ranked based on risk scores, which are calculated by multiplying the sewer severity scores by the environmental impacts. This program is composed of three parts, which are decision-making for sewer condition and performance assessment, decision-making for sewer R&R priority assessment, and decision-making for optimal budget allocation. The SCARD-Program is useful for decision-makers, as it enables them to assess the sewer condition and to prioritize sewer R&R within the limited annual budget. In the future, this program logic will applied to the GIS-based sewer asset management system in local governments.