• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.206-215
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• 2007

Background : The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. Materials and Methods : Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by $NICO^{(R)}$. We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. Results : In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. Conclusion : The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

• Advances in pediatric surgery
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• v.5 no.1
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• pp.15-25
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• 1999

Injured spleens have been successfully managed without operation in a number of children; however, splenectomy or splenic-conserving surgery may not be avoided because of exsanguinating hemorrhage. This study was performed to evaluate the efficacy of splenic arterial embolization (SAE) to control hemorrhage from injured spleens in children. We compared the outcomes of two groups of children with splenic injury. The first group (G1) consisted of eighteen children who were managed with conventional selective nonoperative treatment between 1993 and 1994. The second group (G2) consisted of 23 children prospectively studied from 1996 to 1997 after SAE was added in the management protocol of splenic injury. The criteria for SAE were grade III or IV injury, extravasation of contrast material revealed by CT, or unstable vital signs without evidence of associated injuries. Laparotomy was performed in 6 patients of G1 (33.3 %), 2 of whom had associated injuries. Five underwent splenectomy and the overall salvage rate in G1 was 72.2 % (13/18). In G2, eight patients (34.8 %) had SAE, which stopped bleeding successfully in all patients. Two of G2 (8.7 %) had laparotomy because of associated injuries. Only one patient underwent splenectomy and the salvage rate was 95.6 % (22/23). No patients required transfusion after SAE. In conclusion, the SAE effectively controlled hemorrhage from injured spleens. More spleens were salvaged with a reduced laparotomy rate after application of SAE in splenic injury.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.804-810
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• 1998

Background: Multiple trauma patients have rapidly increased due to traffic accidents, industrial disasters, incidental accidents, and violence. Multiple trauma can involve injuries to the heart, lung, and great vessels and influence the lives, necessitate prompt diagnosis and treatment. Most of the thoracic injuries can be managed with conservative method and simple surgical procedures, such as closed thoracostomy, but in certain cases open thoracotomy is necessary. Materials and methods: The author analyzed the surgical result of 70 cases of open thoracotomy after multiple organ injury including thoracic organ. Results: The most common type of thoracic lesion was hemothorax with or without pneumothorax and diaphragmatic rupture was the second. Sixty percent of the patients were associated with bone fractures, 42.9% with abdominal injuries, and 37.1% with head injuries. The modes of operation were ligations of torn vessels for bleeding control(48.6%), repair of diaphragm(35.7%), and repair of lung laceration(25.7%) in this order of frequency and additional procedures were splenectomy(14.3%), hepatic lobectomy (8.6%) and repair of liver lacerations(5.7%). Postoperative complications were atelectasis (8.6%), wound infection (8.6%), and pneumonia(4.3%). Postoperatively six patients died(The mortality rate was 8.6%) and the causes of death were respiratory failure(2), acute renal failure(2), sepsis(1), and hypovolemic shock(1).

• Journal of Gastric Cancer
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• v.4 no.4
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• pp.282-285
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• 2004

We report a case of advanced gastric cancer with Virchow's node and lung metastasis that responded remarkably to preoperative chemotherapy. A 47-year-old female patient was diagnosed as having incurable advanced gastric cancer with Virchow's node and multiple lung metastasis. Preoperative chemotherapy with Taxotere, CDDP and 5FU was carried out. After four courses of the regimen, the Virchow's node and the lung metastasis had disappeared, and a marked reduction of the gastric lesion was observed on the CT scan. Consequently, the patient underwent a total gastrectomy with D2 lymph node dissection. On histopathological examination, cancer cells were found to have infiltrated up to the muscle layer of the gastric wall, and 42 out of 60 resected lymph nodes were found to be metastatic. The patient received another two courses of chemotherapy after the operation. (J Korean Gastric Cancer Assoc 2004;4:282-285)

• Journal of Radiation Protection and Research
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• v.34 no.3
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• pp.137-143
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• 2009

This study was conducted to evaluate the accuracy of CyberKnife $Synchrony^{TM}$ respiratory tracking system which was applied to Stereotactic Radiosurgery (SRS) for moving tumors in chest and abdomen with breathing motion. For accurate evaluation, gold fiducial marks were implanted into a moving phantom. The moving phantom was a cube imbedding an acryl ball as a target. The acryl ball was prescribed to 20 Gy at 70% of isodose curve in a virtual treatment and radiochromic films were inserted into the acryl ball for dose verification and tracking accuracy evaluation. The evaluation of position tracking consists of two parts: fiducial mark tracking in a stationary phantom and $Synchrony^{TM}$ respiratory tracking in a moving phantom. Each measurement was done in three directions and was repeated to 5 times. Range of position error was 0.1957 mm to 0.6520 mm in the stationary phantom and 0.4405 mm to 0.7665 mm in the moving phantom. Average position error was 0.3926 mm and 0.5673 mm in the stationary phantom and the moving phantom respectively. This study evaluates the accuracy of CyberKnife $Synchrony^{TM}$ Respiratory tracking system, and confirms the usefulness when it's used for Stereotactic Radiosurgery of body organs.

• Journal of the Korean Society of Radiology
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• v.84 no.2
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• pp.409-417
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• 2023

Purpose Patients with bladder cancer may show hematuria after radical cystectomy with ileal neobladder formation, causing anxiety regarding tumor recurrence. Here, we aim to show that the nutcracker syndrome (NCS) can be a cause of hematuria post-operation, and is a common, rather than a rare syndrome. Materials and Methods A retrospective review of contrast-enhanced abdominopelvic CT (CE-APCT) and urine analysis (UA) findings of 255 patients with bladder cancer who underwent radical cystectomy and ileal neobladder formation between 2011 and 2016 was performed. In the CE-APCT review, the left renal vein flow patterns were evaluated to determine the presence of NCS findings. In the UA review, patients were classified according to the percentage of UA tests with positive hematuria among the total number of UA tests. Results CT findings of NCS were present in 31.9% of the 135 patients. In the positive hematuria group, there were 26% more patients with NCS findings than those without. Conclusion NCS findings are prevalent even for bladder cancer patients after surgery, and there is a strong correlation between NCS findings and hematuria. Furthermore, the prevalence of NCS findings is much higher than urinary tract recurrence after the surgery.

• Journal of Veterinary Clinics
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• v.31 no.3
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• pp.246-249
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• 2014

A 9-year-old intact female Shih-Tzu was presented with abdominal pain and abdominal distension. Since the animal's birth, the owner had never observed proestrous bleeding in the patient. Ultrasonography revealed segmental enlargement of the genital system. An ovariohysterovaginectomy was performed to remove the genital mass. The vagina was grossly dilated as a result of being filled with a solid black-green substance. A vaginogram was performed. Based on the surgical findings and vaginogram results, an imperforate hymen was diagnosed. One month from the first surgery, a stump pyocolpos developed between the sutured site and the obstructed portion. The persistent hymen was removed by endoscopy. However, peritonitis and sepsis developed after the procedure, and the dog died. Therefore, During operation of persistent hymen, a cruciate incision over the hymen strongly recommended to avoid additional post operative complications.

• Journal of Veterinary Clinics
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• v.30 no.6
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• pp.503-505
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• 2013

A cross breed dog (6-year-old, 6 kg, intact male) was referred with hematuria. The dog had been treated for years owing to the urinary bladder calculi. On abdominal radiography, prostatic calculus was demonstrated in the prostatic area. In addition, ultrasonography and computed tomography (CT) scan would confirm that the part of calculus protruded within the prostatic urethra. The patient underwent a prostatolithotomy and traumatic prostatic urethra was carefully sutured and the omentum was filled with the prostate lumen. A crystallographic analysis of the stone showed 80% magnesium ammonium phosphate (struvite) and 20% carbonate apatite. The leakage of the urine was not observed post-operation and the hematuria improved and there was no specific problem at the 6 months follow-up.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.115-118
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• 2009

A 65 year-old man, who underwent transthoracic esophagectomy for mid-thoracic esophageal squamous cell carcinoma, suffered from an incarcerated herniation of the transverse colon through a defect in the left mediastinal pleura. The patient had a gas collection in the left lower lung field and this then insidiously progressed; the final result was total collapse of the left lung and hemodynamic compromise. The life-threatening herniation of the transverse colon into the pleural cavity after pervious esophagectomy was corrected by emergency laparotomy. Postoperative pulmonary complications after esophagectomy can induce potentially lethal transhiatal herniation because of the danger of intestinal obstruction or strangulation. The optimal approach to transhiatal herniation after esophagectomy is prevention.

• Advances in pediatric surgery
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• v.10 no.2
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• pp.136-141
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• 2004

Biliary atresia (BA) with extrahepatic biliary cysts (EHBC) is a rare disease. It has been generally recognized as type I (correctable with cystic dilatation), which means a good prognosis. From a total of 73 patients with BA who underwent operation from September 1988 to September 2003 at our institute, 7 (9.6 %) cases of type III BA with EHBC (uncorrectable with cystic dilatation) are reviewed. Clinical findings, laboratory data, radiologic findings, treatment methods and outcomes were reviewed. Female was more prevalent (male to female ratio; 2:5). All cases were type III with EHBC according to the intraoperative cholangiography, and underwent Kasai' s portoenterostomy. The mean age was 57 days at operation. Three patients(42.9 %) are long term survivors. Further evaluation is needed to determine the correlation between prognostic factors and outcome for.