BACKGROUND: In pediatric anesthesia, a method using deliberate endobronchial intubation and auscultation has been used for proper endotracheal tube depth. Tube size, however, may influence on auscultation for air leak between the tube and main bronchus. We attempted to ascertain whether the uncuffed tracheal tube (TT) size affects verifying tube placement by auscultation in children. METHODS: In 23 children, we measured the distance from the carina to the tip of a tube when the first auscultatory sound could be detected on the left chest and when the breathing sound of both chests equalized during withdrawal from right main bronchus. Then, we compared them with those of either a one-size larger or a one-size smaller tube. RESULTS: The distance from the carina to the tip at the first sound was significantly longer in the smaller tracheal tube (1.8 cm vs 1.5 cm, P = 0.01). The tube tip at the equalized breath sounds was 0.6 cm below the carina in both tubes. CONCLUSIONS: These results suggest that detecting endobronchial intubation may be more difficult when using uncuffed tracheal tubes with one-size smaller tube and that auscultation with deliberate bronchial intubation can place the uncuffed TT deeper than an intended depth.
Anesthesia ; Auscultation* ; Bronchi ; Child* ; Humans ; Intubation ; Respiratory Sounds ; Thorax

Female ; Hearing Loss, Noise-Induced ; diagnosis ; Humans ; Leisure Activities ; Male ; Music ; Noise ; adverse effects

Atherosclerosis, which is the most common chronic disease of the coronary artery, constitutes a vascular pathology induced by inflammation and plaque accumulation within arterial vessel walls. Both DNA methylation and histone modifications are epigenetic changes relevant for atherosclerosis. Recent studies have shown that the DNA methylation and histone modification systems are closely interrelated and mechanically dependent on each other.Herein, we explore the functional linkage between these systems, with a particular emphasis on several recent findings suggesting that histone acetylation can help in targeting DNA methylation and that DNA methylation may control gene expression during atherosclerosis.

Children with an intellectual disability often demonstrate lack of cooperation during dental treatment and require behavioral management. A child with mild intellectual disability can be managed adequately using restraints and medication. However, in cases of profound intellectual disability, dental treatment under general anesthesia is usually required. In cases where the patient is an intellectually disabled child who has intellectually disabled parents, it is difficult to evaluate the patient's preoperative condition and to obtain consent for treatment under general anesthesia. Furthermore, they are unable to respond to emergencies after treatment. Therefore, dental treatment should be performed under general anesthesia with hospitalization for children with an intellectual disability. This case presents the dental treatment of an intellectually disabled child, who has intellectually disabled parents, and who required general anesthesia and hospitalization.
Anesthesia, General* ; Child ; Dental Care for Disabled ; Disabled Children* ; Emergencies ; Hospitalization ; Humans ; Intellectual Disability ; Parents*

INTRODUCTIONNoise-induced hearing loss (NIHL) is a preventable condition, and much has been done to protect workers from it. However, thus far, little attention has been given to leisure NIHL. The purpose of this study is to determine the possible music listening preferences and habits among young people in Singapore that may put them at risk of developing leisure NIHL.

METHODSIn our study, the proportion of participants exposed to > 85 dBA for eight hours a day (time-weighted average) was calculated by taking into account the daily number of hours spent listening to music and by determining the average sound pressure level at which music was listened to.

RESULTSA total of 1,928 students were recruited from Temasek Polytechnic, Singapore. Of which, 16.4% of participants listened to portable music players with a time-weighted average of > 85 dBA for 8 hours. On average, we found that male students were more likely to listen to music at louder volumes than female students (p < 0.001). We also found that the Malay students in our study listened to louder music than the Chinese students (p < 0.001).

CONCLUSIONWe found that up to one in six young persons in Singapore is at risk of developing leisure NIHL from music delivered via earphones. As additional risks due to exposure to leisure noise from other sources was not taken into account, the extent of the problem of leisure NIHL may be even greater. There is a compelling need for an effective leisure noise prevention program among young people in Singapore.

Adolescent ; Audiometry ; Female ; Habits ; Hearing Loss, Noise-Induced ; diagnosis ; Humans ; Leisure Activities ; MP3-Player ; Male ; Music ; Noise ; adverse effects ; Risk ; Singapore ; Students ; Young Adult

Behavior management of the child constitutes an important part of pediatric dentistry. The majority of children can be treated with adequate behavior management. However, some children who have extensive dental problems or mental, physical disabilities cannot cooperate. So, the need for general anesthesia as a special method of behavior management has increased recently. This study analyzes the records of patients who received dental treatment under general anesthesia.The 1378 cases of 1322 patients under 18 years of age, who received dental treatment under general anesthesia in department of pediatric dentistry at the Seoul National University dental hospital, from October, 2011 to December, 2015 were included.In this study, male (60.9%) was more than female (39.1%). The mean age of patients was 5.9 years and age from 5 to 9 years was the most frequent (56.0%). The primary dental treatment which patients received was dental caries treatment (51.1%), followed by surgical treatment (42.2%).The dental treatment under general anesthesia has many advantages including of performing a lot of treatments at once, producing good quality of treatment, and reducing the number of visits. General anesthesia may be a useful method of behavior management.
Anesthesia, General ; Child ; Dental Caries ; Female ; Humans ; Male ; Methods ; Pediatric Dentistry ; Seoul