Purpose: This study aimed to explore the psychoemotional changes experienced by mothers of children diagnosed prenatally with congenital heart disease. Methods: Data were collected from March 1 to November 3, 2022, through in-depth interviews with 10 mothers of babies diagnosed prenatally with congenital heart disease in a tertiary hospital. Data were analyzed using Braun and Clarke’s thematic analysis method. Results: The following four themes, with 16 subthemes, were identified: 1) Contemplating maintaining the pregnancy amidst grief and denial, 2) Actively protecting the baby, 3) Recognizing the reality of the disease progression while facing the baby, and 4) Finally becoming a mother. Conclusion: The findings suggest that medical staff should provide accurate information about any disease a baby is diagnosed with before childbirth, understand mothers’ psychoemotional changes, and effectively utilize prenatal counseling. This can be achieved by further expanding the existing patient- and family-centered nursing intervention program implemented by the hospital.
목적 : 본 연구는 레베르 선천성 흑암시 영아에게 라이트박스 시각자극훈련을 적용하였을 때 놀이수준 발달에 미치는 긍정적인 영향을 알아보고자 한다.
연구방법 : 연구 대상자는 레베르 선천성 흑암시 진단을 받아 시각기능 저하를 동반하는 만1세 4개월의 여자 영아 1명이었다. 연구의 진행은 캐나다작업수행측정(Canadian Occupational Performance Measure: COPM)을 사용하여 시각기능과 관련된 세 가지 과제를 선정하고, 라이트박스 시각자극훈련을 일주일에 1회, 30분씩 총 16회를 4개월 동안 실시하였다. 중재효과는 훈련과제의 수행도, 만족도를 평가하였고, 녹스학령전기놀이척도(Knox Preschool Play Scale-Revised: KPPS-R)로 놀이발달 연령을 측정하였다. 또한 보호자 면담 보고를 통해 놀이의 질적인 변화를 알아보았다.
결과 : KPPS-R로 측정한 전반적인 놀이발달 수준은 12개월에서 21개월로 향상되었고 특히, 놀이감 운용 영역은 12개월에 서 22개월로 향상되었다. 훈련과제에 대한 수행도와 만족도는 세 가지 과제에서 2점 이상의 향상을 보여 임상적으로 유용한 결과를 나타냈다. 면담조사 결과, 보호자는 라이트박스 시각자극훈련을 적용하였을 때 놀이와 상호작용에서 긍정적인 변화가 나타났고, 대상자가 시각기능을 적극적으로 사용하게 되었다고 보고 하였다.
결론 : 라이트박스 시각자극훈련은 레베르 선천성 흑암시 영아의 놀이감 운용 발달에 효과적인 중재 방법임을 입증하였으며, 놀이과제의 수행도와 만족도를 향상시키고 놀이의 질적인 향상에도 효과가 있음을 확인하였다.
A 10-day-old, Holstein calf with facial mass of 10 cm in diameter at the forehead region referred to Veterinary Medical Teaching Hospital in Chungnam National University. The mass was soft and fluctuating swelling. It had normal skin and hair hanging forward from frontal region and was thought to contain cerebrospinal fluid.On the skull radiography, cauliflower like-irregular marginated, soft tissue opacity mass was identified craniodorsal to the frontal bone. The mass appeared as a cyst filled with anechoic fluid on ultrasonography. Soft tissue structures considered brain tissues were observed in the deep area of the mass. On the computed tomography, a large skull defect of left side frontal bone was found, and heterogeneous materials were exposed through the defect but exposure of cerebral meninges and brain tissue were not confirmative. On magnetic resonance imaging, herniated left brain parenchyma showed heterogenous T2 and T1 hyperinsensity. In the intracranium, T2 hyperinstense and T1 hypointense fluid was identified on the left side, instead of left cerebral parenchyma. Also leftward shift of right hemisphere and midline structure, including thalamus and midbrain, were observed. The definitive diagnosis was confirmed as a meningoencephalocele based on computed tomography and magnetic resonance imaging. The calf was euthanized and necropsy was performed. On necropsy, both hemisphere were developed unequally with different size. One side hemisphere was grown in the outside through 10 cm hole on the median plane.
Congenital duodenal obstruction is a rare cause of neonatal intestinal obstruction caused by various intrinsic and extrinsic congenital lesions. Annular pancreas is one of the causes of extrinsic duodenal obstruction and a duodenal web is one of the causes of intrinsic duodenal obstruction. The simultaneous occurrence of an extrinsic and intrinsic pathology is rare. Only four such cases have been reported in literature. We present a similar case of male neonate with partial duodenal obstruction caused by annular pancreas and an intrinsic duodenal web.
Oral hyperpigmentation is common in patients older 40 years. But lesions in a newborn are unusual and congenital melanotic macule of the tongue has rarely been reported. A 2-month-old infant with 3 pigmented lesion on the right side of the dorsal tongue was evaluated. They were brown black but not homogeneous in color, smooth, nonblanchable, and nonpalpable, with irregular margins. We recommend excisional biopsy under general anesthesia because of possibility of malignancy, but parents refuse invasive procedure. On a following-up examination of the child at the age of 1 year, the pigmented lesions were unchanged. We report a case of congenital melanotic macules on the tongue and a review of literature about the lesion.
담도 과오종과 선천성 간섬유증은 태생기에 간판 기형에 의해 생기는 섬유 낭성 질환에 속한다. 담도 과오종은 증상 을 유발하지 않고 우연히 발견되는 질환이지만, 선천성 간섬 유증은 25%에서 담관염이 발생하고 증상이 발생하면 항생 제 투여부터 수술까지 적극적 치료가 필요하다. 저자들은 복부 영상 소견으로 담도 과오종으로 진단하고 경과 관찰하던 64세 남자가 2년간 반복적인 담관염이 발생한 원인을 찾기 위해 시행한 간 생검에서 담도 과오종과 선천성 간섬유증이 병합된 것으로 진단한 증례를 경험하여 문헌고찰과 함께 보고한다.
목적:본 연구는 선천성 뇌성마비 환자를 대상으로 경상운동 검사의 신뢰도 및 타당도를 검증하고자 하였다.연구방법:선천성 뇌성마비 편마비 환자로 진단 받은 72명을 대상으로 선행연구에서 제시한 경상운동 검사들의 항목과 점수체계를 재구성하여 경상운동 정도를 평가하였다. 평가된 자료는 Winstep 3.80 version을 사용하여 라쉬분석을 통해 항목과 대상자의 적합도, 항목 난이도, 평정척도, 분리신뢰도를 분석하였다.결과:72명의 뇌성마비 환자 중에 환측에서는 3명, 건측에서는 2명의 환자가 부적합 환자로 나타났다. 각각의 부적합한 대상자를 제외한 69명과 70명의 환자로 항목의 적합도를 분석한 결과, 양측 모두에서 발가락을 사용하여 구슬 잡기 항목이 부적합 판정을 받았다. 항목의 난이도에 대한 분석 결과, 비교적 난이도가 높은 항목은 엄지와 다른 손가락 맞섬하기, 주먹 쥐고 펴기 항목이었으며, 난이도가 낮은 항목은 팔꿈치 굴곡하기, 저항을 이기며 어깨 외전하기 항목으로 나타났다. 평정척도 분석 결과, 4점 척도가 적합한 범주임을 확인하였다. 또한 대상자와 항목의 분리신뢰도는 .90이상의 우수한 값으로 분석되었다.결론:본 연구를 통해 검증된 경상운동 검사가 임상적으로 유용하게 사용되기를 기대하며, 향후 연구에서는 다양한 신경학적 질환의 환자를 대상으로 한 연구가 진행될 필요가 있다.
The purpose of this study is to compare the outcomes of manual stretching treatment with those of motor development and positioning physical therapy (MDPPT) for congenital muscular torticollis (CMT). This study was designed to be randomized controlled trials and to evaluate the outcomes of 43 consecutive patients with CMT who were first seen when they were average 26 days old. Before treatments, the patients were unintentionallv classified into two clinical groups along with the treatment methods. Among the 43 patients, 22 were classified to the manual stretching group and 21 to the MDPPT group. By means of independent t-test on the result. the duration of treatment according to methods was not significantly different in two groups (p>.05). The duration of treatment in accordance with head tilt level was not significantly different in two groups (p>.05). There was change of mass diameter, between at the beginning day of treatment and after treatment in manual stretching group with a strong positive linear correlation (p=.000, r=.734), but slightly positive linear correlation in MDPPT group. The result of this study indicates that two therapeutic methods make little difference in effectiveness.
A two-month-old male calf weighing 70 kg with congenital metacarpophalangeal flexural deformity was referred to the Veterinary Medical Center of Chugbuk National University. The calf could not stand and walk normally that walked with the dorsal surface of the hoof with contraction of fetlock joint. The both forelimbs had been casted two times during 45 days before presentation. Midline of the palmar surface of the feltlock joint was incised to cut superficial flexor tendon, deep flexor tendon and interosseus muscle. Both forelimbs are healed well returned to normal function after tenotomy.
Although conservative management of congenital muscular torticollis (CMT) has been well documented, relatively little is known about the response to the treatment. The purposes of this case report were to describe the use of a therapeutic approach based on motor development in physical therapy intervention for an infant with CMT and to report the result of the treatment. The patient was a 20-day-old baby boy with left CMT presenting muscular mass in the left sternocleidomastoid muscle. The angle of the lateral head tilt was 20 degrees. The size of muscular mass was 5.3 mm in ultrasonography. Intervention included ultrasonic therapy, soft tissue massage, passive and active range of motion exercises, motor developmental therapy, and parent instruction. The procedures of motor developmental therapy and changes in the amount of lateral head tilt were documented using photography. The size of the mass was decreased to .3 mm before the 5-month follow-up. The patient also maintained a midline head position in the supine position and a midline head alignment during all functional activities. A therapeutic approach based on motor development is a beneficial method for reducing an asymmetrical head and neck position, and facilitating normal development as a component of physical therapy intervention.
We experienced an 18-month-old patient with congenital lobar emphysema who underwent one-lung ventilation. With con-sideration that positive pressure ventilation could induce cardiopulmonary distress, induction was performed with spontane-ous breathing using sevoflurane without neuromuscular blocking agent. Bronchospasm occurred after intubation and posi-tion change, twice. He was relieved by administration of neuromuscular blocking agents. We discussed induction methods with minimal positive-pressure ventilation and the treatments for bronchospasm.
A 41-year-old woman arrived at our emergency department with semicomatous mentality due to aborted cardiac arrest from ventricular fibrillation, which occurred during resting state. Prolonged QT interval in condition of hypokalemia and hypomagnesemia was observed on initial electrocardiography. However, even after normalization of serum potassium, magnesium and mentality, QT prolongation was sustained. In addition, genetic analysis showed KCNH2 mutation which was consistent with type 2 congenital long QT syndrome (LQTS). In this case, the patient was treated with an implantable cardioverter defibrillator and genotype specific medical therapy with potassium channel opener.