• Title/Summary/Keyword: 복부수술

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A Case of Mesenchymal Hamartoma Associated with Biliary Atresia (담도 폐쇄증 환아에서 우연히 발견된 간엽 과오종 1례)

  • Choi, Kyung-Dan;Seo, Jeong-Kee;Shin, Eon-Woo;Ko, Jae-Sung;Kim, Woo-Sun;Park, Young-Su;Kang, Kyung-Hoon;Chi, Je-Geun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.1
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    • pp.113-119
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    • 2001
  • Mesenchymal hamartoma is an uncommon benign tumor usually found in childhood, especially during the first two years of life. The tumor consists of a solid component and multiple cyst. Without treatment, these lesions can grow to an enormous size. We experienced a case of mesenchymal hamartoma which was found incidentally, in a 8 month old girl who had ascending cholangitis after Kasai operation due to biliary atresia. On abdominal ultrasonography and CT, there was a well-defined homogeneous small echogenic mass in the right lobe of the liver with cirrhosis. Five months later, she underwent liver transplantation. Gross picture of the resected liver showed a dark greenish pigmented solid mass in the right lobe of the cirrhotic liver. Microscopic findings showed reactive mesenchyma and epithelial overgrowth.

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Usefulness of Application of Tube Voltage Changes to Reduce Patient Dose during Abdominal CT Follow up (반복적인 복부 컴퓨터단층촬영 시행 시 환자선량 감소를 위한 관전압 변화 적용의 유용성)

  • Yoon, Joon;Kim, HyeonJu
    • Journal of the Korean Society of Radiology
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    • v.15 no.3
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    • pp.293-299
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    • 2021
  • In order to reduce the irresistible radiation exposure of patients who perform periodic examinations using a CT among various scan parameters a method to reduce patient dose was investigated through changes in the tube voltage close to X-ray penetrating power. As a result of the experiment 100 kVp was applied instead of 120 kVp which is commonly used in clinical practice and CTDI decreased by about 41% during scan. In addition the degree of change in image quality was measured as 1046.1±3.7 HU for CT value and 71.4±7.9 for Pixel value and statistical analysis showed no significant difference (0.05

Omental Torsion and Infarction Secondary to Omental Hernia in the Right Inguinal Canal (오른쪽 서혜부 탈장에 의해 이차적으로 발생한 대망의 염전 및 경색)

  • Yu Hyun Lee;Jae Hoon Lim;Heon-Kyun Ha
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.1003-1007
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    • 2020
  • Omental torsion secondary to inguinal hernia has rarely been reported as a cause of acute abdominal pain. However, in our case, omental infarction due to prolonged inguinal hernia-associated omental torsion led to the formation of a large omental mass with marginal fibrosis, and the patient presented with chronic abdominal pain. A 74-year-old man presented with complaints of lower abdominal pain for 1 month; subsequently, bilateral inguinal hernias were identified through inguinal ultrasonography. CT scans revealed that the greater omentum was trapped within the right inguinal canal, leading to omental torsion. The greater omentum, distal to the pedicle, appeared as a 30 cm-sized oblong fibrofatty mass in the right lower abdomen and pelvic cavity. Laparoscopic omentectomy with hernia repair was successfully performed.

Comparison of the Mid-term Changes at the Remnant Distal Aorta after Aortic Arch Replacement or Ascending Aortic Replacement for Treating Type A Aortic Dissection (A형 급성대동맥박리증에서 대동맥궁치환술과 상행대동맥치환술 후 잔존 원위부 대동맥의 변화에 대한 중기 관찰 비교)

  • Cho, Kwang-Jo;Woo, Jong-Su;Bang, Jung-Hee;Choi, Pill-Jo
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.414-419
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    • 2007
  • Background: Replacing the ascending aorta is a standard surgical option for treating acute type A aortic dissection. But replacing the aortic arch has recently been reported as an acceptable procedure for this disease. We compared the effects of aortic arch replacement for treating acute type A aortic dissection with the effects of ascending aortic replacement. Material and Method: From 2002 to 2006, 25 patients undewent surgical treatment for acute type A aortic dissection, 12 patients undewent ascending aortic replacement and 13 patients underwent aortic arch replacement. Among the aortic arch group, an additional distal stent-graft was inserted during the operation in 5 patients. 19 patients (11 arch replaced patients and 8 ascending aortic replaced patients) were followed up at the out patient clinic for an average of $756{\pm}373$ days. All the patients undewent CT scanning and we analyzed their distal aortic segments. Result: 4 patients who underwent ascending aortic replacement died, so the overall mortality rate was 16%. Among the 11 long term followed-up arch replacement patients, 2 patients (18.1 %) developed distal aortic dilatation and one of them underwent thoracoabdominal aortic replacement later on. However, among the 8 the ascending aortic replaced patients, 5 patients (62.5%) developed distal aortic dilatation. Conclusion: Aortic arch replacement is one of the safe options for treating acute type A aortic dissection. Aortic arch replacement for treating acute type A aortic dissection could contribute to a reduced distal aortic dilatation rate and fewer secondary aortic procedures.

Comparative Analysis of Patterns of Care Study of Radiotherapy for Esophageal Cancer among Three Countries: South Korea, Japan and the United States (한국, 미국, 일본의 식도암 방사선 치료에 대한 PCS($1998{\sim}1999$) 결과의 비교 분석)

  • Hur, Won-Joo;Choi, Young-Min;Kim, Jeung-Kee;Lee, Hyung-Sik;Choi, Seok-Reyol;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.83-90
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    • 2008
  • Purpose: For the first time, a nationwide survey of the Patterns of Care Study(PCS) for the various radiotherapy treatments of esophageal cancer was carried out in South Korea. In order to observe the different parameters, as well as offer a solid cooperative system, we compared the Korean results with those observed in the United States(US) and Japan. Materials and Methods: Two hundreds forty-six esophageal cancer patients from 21 institutions were enrolled in the South Korean study. The patients received radiation theraphy(RT) from 1998 to 1999. In order to compare these results with those from the United States, a published study by Suntharalingam, which included 414 patients[treated by Radiotherapy(RT)] from 59 institutions between 1996 and 1999 was chosen. In order to compare the South Korean with the Japanese data, we choose two different studies. The results published by Gomi were selected as the surgery group, in which 220 esophageal cancer patients were analyzed from 76 facilities. The patients underwent surgery and received RT with or without chemotherapy between 1998 and 2001. The non-surgery group originated from a study by Murakami, in which 385 patients were treated either by RT alone or RT with chemotherapy, but no surgery, between 1999 and 2001. Results: The median age of enrolled patients was highest in the Japanese non-surgery group(71 years old). The gender ratio was approximately 9:1(male:female) in both the Korean and Japanese studies, whereas females made up 23.1% of the study population in the US study. Adenocarcinoma outnumbered squamous cell carcinoma in the US study, whereas squamous cell carcinoma was more prevalent both the Korean and Japanese studies(Korea 96.3%, Japan 98%). An esophagogram, endoscopy, and chest CT scan were the main modalities of diagnostic evaluation used in all three countries. The US and Japan used the abdominal CT scan more frequently than the abdominal ultrasonography. Radiotherapy alone treatment was most rarely used in the US study(9.5%), compared to the Korean(23.2%) and Japanese(39%) studies. The combination of the three modalities(Surgery+RT+Chemotherapy) was performed least often in Korea(11.8%) compared to the Japanese(49.5%) and US(32.8%) studies. Chemotherapy(89%) and chemotherapy with concurrent chemoradiotherapy(97%) was most frequently used in the US study. Fluorouracil(5-FU) and Cisplatin were the most preferred drug treatments used in all three countries. The median radiation dose was 50.4 Gy in the US study, as compared to 55.8 Gy in the Korean study regardless of whether an operation was performed. However, in Japan, different median doses were delivered for the surgery(48 Gy) and non-surgery groups(60 Gy). Conclusion: Although some aspects of the evaluation of esophageal cancer and its various treatment modalities were heterogeneous among the three countries surveyed, we found no remarkable differences in the RT dose or technique, which includes the number of portals and energy beams.

Awake OPCAB: Initial Experience (의식 있는 상태에서 경막외 마취를 이용한 심박동하 관상동맥우회술: 초기 경험)

  • Son Kuk-Hui;Cho Kwang-Ree;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.598-603
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    • 2006
  • Background: High thoracic epidural anesthesia allows awake coronary artery bypass grafting, avoiding the drawbacks of mechanical ventilation and general anesthesia. Materian and Method: From April, 2005 to September, 2005, 12 patients were underwent awake coronary artery bypass grafting using high thoracic epidural anesthesia. There were 1 female and 11 male patients, with a mean age of $66{\pm}6$ years. Off pump coronary artery. bypass grafting was performed through a median sternotomy using arterial grafts. Result: There were no mortality. Pneumothorax was developed during surgery in 8 patients. Five patients required secondary intubation because of pneumothorax (n=3), bowel herniation (n=1), and hemothorax after chest tube insertion (n=1). Postoperative coronary angiography was performed before discharge in all patients and all the grafts were patent. Conclusion: Our intial experience demonstrated the feasibility of awake off-pump coronary artery bypass grafting. Further study is required to define the indications, advantages and limitations of this strategy.

Multidetector CT Findings of Solid Organ Injury Based on 2018 Updated American Association for the Surgery of Trauma Organ Injury Scaling System (2018 개정 미국외상수술협회 복부고형장기 손상척도에 따른 다중검출 CT 소견)

  • Hyo Hyeon Yu;Yoo Dong Won;Su Lim Lee;Young Mi Ku;Sun Wha Song
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1348-1363
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    • 2020
  • The newly revised 2018 Organ Injury Scale (OIS) has a similar format to the previous American Association for Surgery and Trauma (AAST) Emergency General Surgery Grading System, dividing the criteria for grading solid organ damage into three groups; imaging, operation, and pathology. The most significant alteration in the OIS system 2018 revision is the incorporation of multidetector CT (MDCT) findings of vascular injury including pseudoaneurysm and arteriovenous fistula. Similar to the previous OIS, the highest of the three criteria is assigned the final grade. In addition, if multiple grade I or II injuries are present, one grade is advanced for multiple injuries up to grade III. This pictorial essay demonstrates the MDCT findings of solid organ injury grades based on the 2018 OIS system.

Aqueous Extracts of Jibaekjihwang-tang Ameliorate Ovariectomy-induced Climacterium Symptoms in Mouse (난소적출 마우스에서 지백지황탕 열수 추출물의 갱년기 장애 개선 효과 평가)

  • Lee, Seung-Hye;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.2
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    • pp.16-36
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    • 2017
  • Objectives: The purpose of this study was to evaluate the anti-climacterium effects of Jibaekjihwang-tang (JBJHT), especially on estrogenic, anti-obesity, hypolipidemic, hepatoprotective against fatty liver and anti-osteoporotic effects by Ovariectomy (OVX) mice. Methods: In order to evaluate anti-climacterium effects of JBJHT, we used bilateral OVX female ddY mice. In this study, six groups were used; sham control, OVX control, estradiol, JBJHT 500, 250 and 125 mg/kg treated groups. Since 28 days after OVX surgery, JBJHT extracts were orally treated, and $17{\beta}$-estradiol $0.03{\mu}g/head$ were subcutaneously injected for 84 days, once a day. And then, we observed anti-climacterium effects classified into five categories; estrogenic, anti-obesity, hypolipidemic, hepatoprotective against fatty liver and anti-osteoporotic effects. The results were compared with $17{\beta}$-estradiol $0.03{\mu}g/head$/day subcutaneous treated OVX mice. Results: OVX control mice showed noticeable hypertrophic changes of adipocytes in abdominal fat pads, fatty liver, uterine atrophic changes, decreases of bone strength were also observed in OVX control. However, these estrogen-deficient climacterium symptoms were significantly and dose-dependently inhibited by JBJHT 500, 250 and 125 mg/kg treatment. Moreover, JBJHT 500 mg/kg showed comparable inhibitory effects as compared to those of estradiol $0.03{\mu}g/head$/day subcutaneous treatment. Conclusions: The results suggest that oral administration of JBJHT 500, 250 and 125 mg/kg has clear dose-dependent anti-climacterium effects in OVX mice.

Clinical Evaluation of Patients with Unilateral Non-functioning Kidney on $^{99m}Tc-DMSA$ scan ($^{99m}Tc-DMSA$ 스캔에서 일측성으로 동위원소 섭취가 안되는 환아들에 대한 임상적 고찰)

  • Bae Hyun-Chul;Kim Hyun-Young;Kim Pyung-Kil;Han Sang-Won
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.31-37
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    • 1997
  • The DMSA scan is a useful radiologic study in diagnosis of morphologic and functional diseases of kidney. We evaluated the distribution of sex and age, clinical manifestations, diagnosis, combined diseases, treatment and prognosis of the 61 patients with non-functioning kidney(no isotope uptake or uptake below 5% in DMSA scan) who admitted in our hospital from 1980 to 1995. The proportion of patients under 1 year old age was 46%. Sex ratio was 1.4:1 with male predominance. Most diagnosis of non-functioning kidneys were congenital such as multicystic dysplastic kidney, hydronephrosis due to ureteropelvic junction obstruction, renal agenesis and renal hypoplasia. In order of frequency thirty one percent of them were previously detected on antenatal ultrasonogram. Treatment consisted of operation in 47.5%, mostly nephrectomy and 32.8% of patients were followed up at OPD base without definite treatment. The most common combined diseases was hydronephrosis, in 4patients who had both kidneys inveloved progressed to chronic renal failure, but the prognosis in most cases were good. It is important to evaluate renal diseases in perinatal periods, and we believe that highly sensitive diagnostic study contribute to early treatment plan and thus to good prognosis.

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Primary Ureteral Transitional Cell Carcinoma in a Dog (개에서 발생한 원발성 요관 이행세포암종 증례)

  • Kim, Seong-soo;Lee, Jeo-soon;Yun, Soo-kyung;Kim, Su-yeon;Oh, Hyun-jung;Sohn, Jung-min;Jung, Sun-young;Kim, Bo-eun;Ji, Seo-yeoun;Kim, Dae-yong;Kim, Wan-hee;Yoon, Jung-hee;Choi, Min-cheol
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.459-463
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    • 2015
  • A 14-year-old, castrated male mixed-breed dog weighing 9 kg was presented for hematuria and dysuria. Abdominal ultrasound showed unilateral hydronephrosis and hydroureter with focal thickening of the ureteral wall. Surgical exploration revealed an intraluminal mass arising from the proximal left ureter. Mass resection was performed. Histopathology of the ureteral mass was consistent with a papillary transitional cell carcinoma. The patient recovered well post-operatively, but was diagnosed with another tumor three months later, this time in the right kidney. Fine-needle aspiration cytology of the renal mass revealed an epithelial cell tumor with mesenchymal features.