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생후 15일된 신생아에서 발병한 악하부 농양 치험 1예
박영실,곽동석,황인옥 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.6
Submandibular gland abscess is exceptionally rare in neonates. We present a case of submandibular gland abscess and etiology, investigations and treatment for this very rare condition. The patient was a 15-day-old neonate with a swelling in the right submandibualr region. She was born after a full term and showed a sign of dehydration. An ultrasound examination demonstrated a multiple lobulated echoic lesion and the right submandibular gland was nonvisible. A CT scan revealed a hypodense round mass measuring 2.5×2.8×2.8 cm and a multiple hyperdense lesion, but no right submandibular glands. A dignosis of submandibular abscess in association with acute suppurative sialadenitis was made. Under general anesthesia, the neck abscess was drained by a 2-cm long incision at two finger-breadths (3 cm) below the inferior border of the ramus of mandibule. A large amount of greenish pus emerged immediately after dividing the platysma. The submandibular salivary gland was nearly not found. Specimen from the pus were taken for the culturing of bacteria, fungi, actinomycetes, and tuberculosis. The wound was irrigated by normal saline and penrose drain was inserted. The antibiotics was administered for 7 days. A three-week follow-up showed no evidence of infection.
Availability of peripheral inserted central catheters in severe hemophilia patients with inhibitors
박영실 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.12
The most effective treatment strategy for patients with hemophilia is replacement therapy with FVIII or FIX concentrates, which usually requires long-term, uncomplicated venous access. However, central venous access device (CVADs, ports) insertion requires inpatient admission and general anesthesia, and presents some problems regarding health insurance coverage. Peripherally inserted central catheters (PICCs) were inserted in two severe hemophilia patients aged 7 and 11 years with high titers of inhibitors. They experienced frequent bleeding episodes and required replacement therapy, which eventually resulted in difficulty in acquiring venous line access. Factor VIII activity was below 1%, and inhibitor titers were 160 and 26.3 BU/ml. In an outpatient setting, PICC lines are easily placed by radiological guidance and require local anesthesia alone. PICC has been feasible, in particular, for hemophilia patients with frequent bleeding episodes.
Multiple births conceived by assisted reproductive technology in Korea
박영실,최선희,심계식,장지영,한원호,최용성,배종우 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.10
Purpose: The recent trends of multiple births (MBs) conceived by assisted reproductive technology (ART) in Korea were analyzed as well as the relationship with maternal age, especially advanced maternal age. Methods: Data were obtained from the Korean Statistical Information Service and annual ART reports from the ART committee of the Korean Society of Obstetrics and Gynecology. Results: MBs increased from the early 1990s; there was a 275%increase by 2008. The number of total live births was 448,153 and MBs accounted for 10,767; the MB rate was 24.0% in 2006. Among 2,326 deliveries conceived by ART, multiple deliveries accounted for 786 (33.8%). The total number of live births with ART was 3,125 and 1,585 (50.7%) of them were MBs. During 2006, 14.7% of the entire MBs in Korea were associated with ART. The proportion of women of advanced maternal age was much higher in the ART group than in the total live birth group. Conclusion: MBs in women of advanced maternal age have been increasing in Korea with the use of ART. The results of this study showed that ART was a significant factor associated with the increase in MBs in Korea.