With the improvement of the instrument and technic, the gastrofiberoscope has been used not only in diagnostic purpose but in therapeutic purpose. One purpose of the therapeutic methods is to remove the gastric foreign bodies. So many type and shape of forceps and baakets have been usad. for the same purpose. ifn these easea, we uaed biopsy farcep and snare to remove swallowed toothbrushes, three casea in the stomaeh and one cuse in the duodenurn.
Biopsy ; Foreign Bodies ; SNARE Proteins ; Surgical Instruments

No abstract available.
Meningitis* ; Salmonella*

Osteogenesis imperfecta is a heterogeneous group of disorders that are characterized by connective tissue defects resulting in bone fragility, blue sclera, impaired hearing, defective dentition, and hyperlaxibility of the joints. The overall incidence of osteogenesis imperfecta is estimated at 1/25,000. We recently experienced a case of osteogenesis imperfecta type II diagnosed in uterus by ultrasonogram and confirmed after termination of pregnancy and autopsy. We report a case here with a brief review of the literature.
Autopsy ; Connective Tissue ; Dentition ; Diagnosis* ; Hearing ; Incidence ; Joints ; Osteogenesis Imperfecta* ; Osteogenesis* ; Pregnancy ; Sclera ; Ultrasonography* ; Uterus*

The prenatal diagnosis of spina bifida includes the combined use of maternal serum alpha-fetoprotein (MSAFP) screening and fetal sonography. On ultrasonogram, spina bifida is characterizd by visualization of the spinal defect and associated cranial abnomalities: the Lemon sign, the Banana sign, ventriculomegaly, small biparietal diameter, and obliteration of the cisterna magna. We should now be able to rely on ultrasound as the main technique for diagnosis of spina bifida when MSAFP is elevated. Recently, we have experienced three cases of spina bifida diagnosed with meningomyelocele, lemon sign, banana sign and ventriculomegaly on ultrasonogram at respectively 18+3, 18, and 18+6 weeks of gestation. We present these cases with a brief review of literatures.
alpha-Fetoproteins ; Cisterna Magna ; Diagnosis ; Mass Screening ; Meningomyelocele ; Musa ; Pregnancy ; Prenatal Diagnosis ; Spinal Dysraphism* ; Ultrasonography*

PURPOSE: In the present study, we aimed to determine the risk factors for the development of cystic periventricular leukomalacia (CPVL) in very low birth weight (VLBW) infants. METHODS: We reviewed the medical records of 309 infants weighing less than 1,500 g who were admitted to the neonatal intensive care unit at Hanyang University Medical Center, Seoul from April 2007 to December 2012. Thirty-nine infants died within 28 days of birth. Of the remaining 270 infants, 21 with CPVL established by cranial ultrasonography, and 63 without CPVL, who were matched for gestational age, were enrolled in this study. Univariate and multivariate analyses of maternal, perinatal, and neonatal risk factors for CPVL were performed through retrospective assessment of data collected from the medical records. RESULTS: Necrotizing enterocolitis (NEC > or =stage II: 42.9% vs. 9.5%, P=0.002), culture-proven sepsis (66.7% vs. 34.9%, P=0.021), hypotension with sepsis (33.3% vs. 6.3%, P=0.004), and severe intraventricular hemorrhage (> or =grade III: 61.9% vs. 22.2%, P=0.002) were associated with the development of CPVL on univariate analysis. Using multivariate logistic regression analysis, two variables were found to be statistically significant independent risk factors: NEC (> or =stage II: adjusted OR, 5.12; 95% CI, 1.219-21.514; P=0.026) and hypotension with sepsis (adjusted OR, 8.23; 95% CI, 1.194-56.713; P=0.032). CONCLUSION: NEC (> or =stage II) and hypotension with sepsis were associated with an increased risk of developing CPVL in VLBW infants.
Academic Medical Centers ; Enterocolitis, Necrotizing ; Gestational Age ; Hemorrhage ; Humans ; Hypotension ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Leukomalacia, Periventricular* ; Logistic Models ; Medical Records ; Multivariate Analysis ; Parturition ; Retrospective Studies ; Risk Factors* ; Seoul ; Sepsis ; Ultrasonography

PURPOSE: The aim of the study was to investigate the change in usage and clinical outcomes of using a humidified high flow nasal cannula (HHFNC) in preterm infants. METHODS: A retrospective review of patients with gestational age <32 weeks born at our neonatal intensive care unit from January 2008 to March 2011 was performed. First, data were compared between Era 1 (January 2008 to February 2009) and Era 2 (March 2009 to March 2011) to describe the increased usage of HHFNC. Second, the patients (gestational age 25-30 weeks) were divided into two groups to compare clinical outcomes. nasal continuous positive airway pressure (NCPAP) and HHFNC groups who received either NCPAP or HHFNC as a respiratory support within 14 days of birth. RESULTS: Compared to Era 1, HHFNC usage increased from 10 to 55% in Era 2, whereas NCPAP usage decreased from 40 to 5%. No difference in pulmonary or adverse outcomes including the incidence of reintubation and bronchopulmonary dysplasia (BPD), days on oxygen and a ventilator, and other outcomes was observed between the HHFNC and NCPAP groups. Days to reach full feed (32.2+/-16.7 vs. 24.7+/-10.2, P=0.05) and regain birth weight (20.9+/-16.9 vs. 17.2+/-4.3, P=0.04) decreased in the HHFNC group. CONCLUSION: HHFNC was feasible and did not differ in respiratory and other outcomes, but days to reach full feed and regain birth weight decreased in the HHFNC, when compared with the NCPAP. An additional prospective multicenter designed study is needed to better define safety and efficacy of HHFNC.
Birth Weight ; Bronchopulmonary Dysplasia ; Catheters ; Continuous Positive Airway Pressure ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Oxygen ; Retrospective Studies ; Ventilators, Mechanical

PURPOSE: Ibuprofen is used for prevention and treatment of patent ductus arteriosus as an alternative drug of indomethacin in very premature infants. We aimed to determine the effect of prophylactic ibuprofen on patent ductus arteriosus and clinical outcomes in preterm infants less than 1,250 g. METHODS: A retrospective review of 39 preterm infants who were admitted to our neonatal intensive care unit from November 2009 to July 2010 was performed. Patients were divided into a prophylactic group (n=13) and a matched historical control group (n=26), where prophylactic ibuprofen were administrated within 24 hours after birth. The rate of ductal closure, side-effects of drug treatment and clinical outcomes were compared between two groups. RESULTS: Comparison of the prophylactic and control groups revealed no significant differences in the rate of ductal closure (69.2% vs 77.7%, P=0.825) and surgical ligation (23.1% vs 30.8%, P=0.719). Occurrence of bowel perforation was more frequent in the prophylactic group than the control group, but was not significant (30.8% vs 11.5%, P=0.194). The frequency of intraventricular hemorrhage (grade> or =3) and other outcomes did not differ between the groups. CONCLUSION: Ibuprofen prophylaxis in preterm infants did not decrease the rate of ductal closure, the need for surgical ligation and the incidence of intraventricular hemorrhage. Further studies are needed to investigate the beneficial effect and associated adverse events attributed to ibuprofen prophylaxis.
Birth Weight ; Ductus Arteriosus, Patent ; Hemorrhage ; Humans ; Ibuprofen ; Incidence ; Indomethacin ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Ligation ; Parturition ; Retrospective Studies

PURPOSE: Early administration of parenteral amino acids has been shown to limit catabolism and improve growth in extremely low birth weight infants (ELBWI). This study aimed to evaluate the relationship between an earlier aggressive administration of amino acids and blood urea nitrogen (BUN). METHODS: We retrospectively analyzed the medical records of all ELBWI who were born and admitted to Hanyang University Hospital from March 2007 to December 2009. The high initial dose group received > or =3.0 g/kg/d amino acids, while the lower initial dose group did not received a minimum of > or =3.0 g/kg/d parenteral AA at < or =3 days of age. RESULTS: There were no differences in gestational age, birth weight and sex between the groups. Mean fluid intake and total calories during the first 48 hours of life were similar between two groups. There is no correlation between amino acid intake and BUN level in ELBWI during study period. However, gestational age showed a significant negative correlation with BUN level in ELBWI on day 3 and 7. CONCLUSION: An earlier, more aggressive administration of amino acids was safe and well-tolerated. There is no correlation between amino acid intake and BUN level in ELBWI infants within 7 days of life.
Amino Acids ; Birth Weight ; Blood Urea Nitrogen ; Gestational Age ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Medical Records ; Retrospective Studies

BACKGROUND: Increasing age and loss of teeth weaken oral muscle strength. This study aimed to investigate the positive effects of orofacial myofunctional training on elderly people.METHODS: Thirty six elderly individuals in a welfare center and a senior citizen center were included in this study. A survey regarding lip and tongue strength suvsequent to orofacial myofunctional training and oral health-related quality of life was conducted from April to June, 2019. Data were analyzed using PASW statistics ver. 18.0.RESULTS: The experimental group, showed an increase in lip strength (from 9.79 to 10.31) and tongue strength (from 41.26 to 43.97) after orofacial myofunctional training. The perception of oral health-relatedquality of life was enhanced (from 2.26 to 2.07). In particular, the frequency of dry cough for food removal while swallowing decresed due to an incresed in the secretion of saliva (p<0.05). Correlation analysis showed that the number of functional teeth was positively related to oral health-related quality of life.CONCLUSION: Orofacial myofunctional training for improving lip and tongue strength is effective in the elderly. In older societies, oral strength should be maintained to improve oral health-related quality of life. It also suggests the interest of oral health workers and applying orofacial myofunctional training programs.
Aged ; Cough ; Deglutition ; Education ; Humans ; Lip ; Muscle Strength ; Myofunctional Therapy ; Oral Health ; Quality of Life ; Saliva ; Tongue ; Tooth

PURPOSE: The purpose of this study was to propose a technique for periodontal biotype modification through thickening of the entire facial aspect using a volume-stable collagen matrix and autogenous subepithelial connective tissue graft (CTG) for the treatment of gingival recession. METHODS: Four systemically healthy patients showing Miller class I or class II gingival recession in the mandibular incisor area were included in this study. Full-mouth scaling and root planing procedures were performed at least 4 weeks prior to periodontal plastic surgery. A split-thickness flap with a horizontal intrasulcular incision and 2 vertical incisions was used in cases 1–3, and the modified tunnel technique was used in case 4 for coronal advancement of the mucogingival complex. After the exposed root surfaces were debrided thoroughly, double-layered volume-stable collagen matrix was placed on the apical part of the recession and a subepithelial CTG harvested from the palatal area was placed on the coronal part. The amount of root coverage at 3 months postoperatively was evaluated in cases 1–3, and facio-lingual volumetric changes were analyzed in cases 1 and 2. RESULTS: Healing was uneventful in all 4 cases and complete root coverage was shown in cases 1–3. In case 4, reduction of gingival recession was observed at 3 months after surgery. In cases 1 and 2, a comparison of stereolithographic files from the preoperative and postoperative time points demonstrated that the entire facio-lingual volume had increased. CONCLUSIONS: The surgical technique suggested herein, using a volume-stable collagen matrix and autogenous subepithelial CTG, may be an effective method for periodontal biotype modification through thickening of the entire facial aspect for the treatment of gingival recession.
Collagen ; Connective Tissue ; Gingival Recession ; Humans ; Incisor ; Methods ; Root Planing ; Surgery, Plastic ; Transplantation ; Transplants