Brain Injuries ; Humans ; Premature Birth ; Research

Traction injuries of the brachial plexus have recognized since the classic descriptions of Duchenne, Erb and Klumpke. The original cases resulted from birth injuries, presumably from traction forces. In recent years, automobile accidents have resulted in and increase in traction or closed injuries to the brachial plexus. This paper reviews our experiences with 3 cases of injuries characteristically demonstrated by Pantopaque myelography.
Automobiles ; Birth Injuries ; Brachial Plexus ; Iophendylate ; Myelography ; Traction*

This paper reviews the mechanisms of brachial plexus injury which includes the traumatic: stretch/contusions with or without avulsion, gunshot wounds(GSWs) and lacerations and the nontraumatic from tumors and the various etiologies of thoracic outlet syndrome(TOS). Another type of brachial plexus injury is that of obstetrical birth injury. The paper also reviews the anatomy of the brachial plexus and operative approaches with the anterior approach used in the majority of cases. The posterior subscapular approach with resection of the first rib is occasionally used for tumor resection, GSWs of the lower roots and trunk and the majority of patients with TOS. Surgical techniques and their indications in brachial plexus surgery are presented including nerve action potential(NAP) recording, neurolysis, end-to-end suture anastomosis repair and graft repair including split-repair. The mechanisms of brachial plexus injury are individually reviewed and results for each type of repair of same from the Louisiana State University Health Sciences Center(LSUHSC) experience with 1, 019 patients between 1968-1998 are summarized. There were 509 (49%) stretch/contusion injuries, which was the majority lesion followed in number by brachial plexus GSWs (12%) and lacerations (7%). Nontraumatic brachial plexus injuries included tumors (16%) and TOS (16%). Obstetrical brachial plexus injury though not included with the 1, 019 patients presented in a paper by Kim and Kline et al (J Neurosurg 98: 1005-1016, 2003) are presented and the LSUHSC experience with these are included as well.
Birth Injuries ; Brachial Plexus* ; Humans ; Lacerations ; Louisiana ; Ribs ; Sutures ; Transplants

OBJECTIVETo compare the difference of therapeutic effect between acupuncture combined with Tuina and Nobex for treatment of birth brachial plexus injury.

METHODSForty cases with birth brachial plexus injury were randomly divided into a acupuncture combined with Tuina group (group A) and a Nobex group (group B), 20 cases in each group. The group A was treated with acupuncture at 3 points, i. e. Jianyu (LI 15), Jianliao (TE 14), Jianzhen (SI 9) on shoulder, Binao (LI 14), Shouwuli (LI 13), Quchi (LI 11), etc. combined with Tuina using a single thumb and rolling method, and the group B was treated with intramuscular injection of Nobex. The clinical effects and the changes of the symptom, scores and the electromyogram were observed before and after treatment.

RESULTSThe total effective rate of 90.0% (18/20) in the group A was better than that of 55.0% (11/20) in the group B, with a significant difference between the two groups (P < 0.05). The effective rate of the electromyogram improvement in the group A was 90.0% (18/20), which was better than 45.0% (9/20) in the group B (P < 0. 05), and the symptom scores in the group A were lower than those in the group B (P < 0.01).

CONCLUSIONAcupuncture combined with Tuina can improve the recovery of nerve and upper extremity function and its therapeutic effect is superior to that of intramuscular injection with Nobex.

Acupuncture Therapy ; Birth Injuries ; physiopathology ; therapy ; Brachial Plexus ; injuries ; physiopathology ; Combined Modality Therapy ; Female ; Humans ; Infant ; Male ; Massage

Among 2,055 cases of abnormal findings detected by prenatal ultrasonography at Yonsei University College of Medicine from January 1996 to June 2002, the incidence and the site of cystic hygroma were evaluated. The clinical courses and postnatal prognosis were studied in four cases with cystic hygroma developed in unusual sites. Among 2,055 cases of abnormal ultrasonographic findings, 76 cases (3.70%) were diagnosed as cystic hygroma. Among 76 cases of cystic hygroma, 4 cases (5.3%) were detected in unusual sites; 1 case in mediastinum, 1 right axillary area, and 2 in anterolateral portion of neck. In cystic hygroma, prenatal accurate ultrasonographic findings including size and site of mass are important. Cystic hygroma developed in unusual sites are associated with perinatal complications including airway obstruction and compression of the surrounding organs. In giant cystic hygroma, cesarean section should be considered to avoid trauma and birth injury. After delivery, close observation and proper management are required.
Airway Obstruction ; Birth Injuries ; Cesarean Section ; Female ; Incidence ; Lymphangioma, Cystic* ; Mediastinum ; Neck ; Pregnancy ; Prognosis ; Ultrasonography, Prenatal

Depressed skull fractures in newborn babies mainly result from birth injury and rarely occurr in intrauterine life without any definable etiology. We present 4 cases of congenital intrauterine depressed skull fractures which were discovered at birth in neonates. Three babies (case 1, 2, 3) had round shallow depressions without adjacent soft tissue injury except the last one (case 4), showing sharp angulation in the center of the depression. They had neither birth trauma nor forceps applications and they were healthy without neurologic symptoms. We performed nonsurgical reduction using vacuum extractor in all cases. Three cases were reduced successfully, but the last one failed due to sharp angulation in the center of the depression. It was reduced successfully by surgical elevation using a Freer elevator. Reduction should be performed in congenital depressed skull fractures without neurologic symptoms, because brain compression by depressed fracture results in brain injury or epileptic focus. Nonsurgical reduction should be prior to surgical reduction because of its technical feasability, safety and good results, but surgical reduction should be attempted in the case of sharp angulation in the center of the depression.
Birth Injuries ; Brain ; Brain Injuries ; Depression ; Elevators and Escalators ; Humans ; Infant, Newborn* ; Neurologic Manifestations ; Parturition ; Skull Fracture, Depressed* ; Soft Tissue Injuries ; Surgical Instruments ; Vacuum

PURPOSE: This study was performed to compare complications and perinatal factors according to the birth weight groups in the infants of diabetic mothers(IDM). METHODS: Three hundred and one singleton diabetic mothers and their babies of more than 30 weeks' gestational age admitted in the department of Pediatrics, Chonnam University Hospital from January 1996 to March 2002 were enrolled. Complications and perinatal factors were compared between large for gestational age(LGA) and appropriated for gestational age(AGA) infants. RESULTS: Hypomagnesemia was observed in 37.5%, jaundice in 21.3%, hypoglycemia in 11.1%, hypocalcemia in 7.0%, and birth injury in 19.6%. Congenital anomaly was noted in 24.9% with cardiovascular anomaly most commonly. In the LGA group, the frequencies of jaundice, hypoglycemia, tachypnea, and birth injuries were higher, and the interventricular septum was thicker than the AGA group. In the LGA group, Cesarean section rate, maternal height, weight before pregnancy, weight gain during pregnancy, and the incidence of unawareness of gestational DM were significant compared with the AGA group. CONCLUSION: In the LGA group, the frequencies of jaundice, hypoglycemia, tachypnea, and birth injuries were higher, and the interventricular septum was thicker than the AGA group. In the LGA group, maternal height, weight before pregnancy and weight gain during pregnancy were larger, and the incidence of unawareness of gestational DM was higher compared with the AGA group. These results suggest that careful examination and management are needed to detect the high risk, pregnant DM mothers with possible LGA babies.
Birth Injuries ; Birth Weight* ; Cesarean Section ; Female ; Gestational Age ; Humans ; Hypocalcemia ; Hypoglycemia ; Incidence ; Infant* ; Jaundice ; Jeollanam-do ; Mothers* ; Parturition* ; Pediatrics ; Pregnancy ; Tachypnea ; Weight Gain

PURPOSE: Epidural hematoma (EDH) in newborn is very rare, but when it occurs it is usually due to birth injury. We have evaluated the incidence and clinical features of EDH related to birth in newborn. METHODS: We analyzed medical records of 12 newborns diagnosed with EDH at Cheil General Hospital and Women's Health Care Center from January 2000 to December 2015 retrospectively. RESULTS: The incidence of EDH related to birth was 0.01%, occurring in 1 of 10,000 live births. Of the total 12 cases, 10 occurred in male and 8 in vaginal delivery. Among them, 11 infants had evidences of birth injury. Clinical presentation was nonspecific: only 1 infant had neurologic symptoms. The temporooccipital area was the most frequent location of EDH. The median size of EDH was 3.2±0.8 cm in length and 1.2±0.7 cm in depth. Mass effect accompanied with midline shift on radiologic imaging was shown in one case. Surgical drainage was needed only in one infant with neurologic symptom and mass effect on radiologic imaging, while the others were treated conservatively. CONCLUSION: Neonatal EDH related to birth was treated conservatively in most cases. The radiologic mass effect and neurologic symptom should be considered as indication for surgical intervention.
Birth Injuries ; Drainage ; Hematoma* ; Hospitals, General ; Humans ; Incidence ; Infant ; Infant, Newborn* ; Live Birth ; Male ; Medical Records ; Neurologic Manifestations ; Parturition* ; Retrospective Studies ; Women's Health

To use basic data for health planning and evaluation of Kangwha community health project of Yonsei University, a study on death rates and causes of death were investigated in two townships (Naega and Sunwon Myuns) in Kangwha County from April 1, 1975 to March 31, 1977). All death was identified and reported by family health workers who are living in each village and 2 trained public health nurses confirmed the death. The causes of death were investigated by 2 public physicians. Total number of deaths for 2 years was 230 and the followings are brief summary of the study. 1. Age-adjusted crude death rates of study area were 8.69 per 1,000 population in 1975 and 7.18 per 1,000 population in 1976. Age-adjusted crude death rates for male were 9.18 in 1975 and 6.38 in 1976 and for female were 8.33 and 7.80 per 1,000 population. 2. Age specific death rate curves by year and sex showed "U" shapes. 3. Infant and neonatal death rates were 30.08 and 22.56 per 1,000 live births in 1975, and the rates in 1976 were 18.18 and 13.64. 4. The most common cause of death was cerebrovascular disease and average cause specific death rate for the disease was 215.5 per 100,000 population. 5. Four leading causes of death were non-infectious origin ; cerevrovascular disease, malignant neoplasms, senility and suicide. Pulmonaty tubeculosis and pneumonia occupied 5th and 9th causes of death. 6. Stomach cancer and hepatoma occupied 61.3% of total death due to malignant neoplasms. 7. Most frequent cause of neonatal death was birth injury. Two deaths due to tetanus were found in 1975, but no death due to this disease was found in 1976. 8. About half of deceased received care from physician before death.
Birth Injuries ; Carcinoma, Hepatocellular ; Cause of Death* ; Family Health ; Female ; Health Planning ; Humans ; Infant ; Live Birth ; Male ; Mortality* ; Nurses, Public Health ; Pneumonia ; Stomach Neoplasms ; Suicide ; Tetanus

Clinical and statistical observations were performed on 744 cases of meonates which were admitted in the nursery, Kyungpook National University Hospital, during the 3 years from January 1973 to December 1975. The results were as following : 1) Sex ratio of male to female was 1.02:1. 2) The mortality rate of neonates was 19.1 per 1000 neonates, and the majority of neonatal deaths was low birth weight neonate (78.6%) and no sex difference. 3) The causes of deaths in order of frequency were prematurity (42.9%), respiratory disease (21.4%), congenital anormalies (21.4%), birth injury (7.1%), and unknown causes (7.1%). 4) Gestational period of the neonates was as following ; under 38 weeks : 101 cases (13.6%) between 38 weeks and 42 weeks : 594 cases (79.8%) above 42 weeks : 49 cases (6.6%) 5) The percentage distribution was 15.2% for 2,500gm or less (16.8% in male, 13.6% in female), 81.8% for 2,500~4,000gm, and 3.0% for 4,000gm or above. 6) Estimation of growth datas in neonates was as following ; Weight : 3.28kg in male, 3.19kg in female Height : 50.8cm in male, 50.6cm in female Head circumference : 34.0cm in male, 33.8cm in female Chest circumference : 32.5cm in male, 33.7cm in female 7) The incidence of the neonatal jaundice was 63.4% of all neonates and no differences in weight and sex respectively. 8) The incidence of twin pregnancy was 3.0% and sex ratio was 1.1:1 in male preponderance.
Birth Injuries ; Cause of Death ; Female ; Gyeongsangbuk-do ; Head ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn* ; Jaundice, Neonatal ; Male ; Mortality ; Nurseries ; Pregnancy, Twin ; Sex Characteristics ; Sex Ratio ; Thorax