• Title/Summary/Keyword: 천공경

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Subphrenic Abscess Due to Retained Gauze (체내에 남은 거즈가 원인인 횡경막 하 농양)

  • Hwang, Eui-Doo;Won, Tae-Hee;Kim, Si-Wook;Na, Myung-Hoon;Yu, jae-Hyun;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.105-107
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    • 2004
  • Eighty-four-year old man who had lapalotomy for stomach ulcer perforation 35 years ago was admitted for left lower chest discomfort. Chest X-ray and CT showed a large mass with air fluid level in left lower lung field. The tentative diagnosis was infected bronchogenic cyst. After a thoracotomy, the mass was confirmed as elevated diaphragm and subphrenic abscess with a foreign body, retained surgical gauze. The pus and gauze were located between stomach and diaphragm. His hospital course was smooth and uneventful, he was discharged with good outcome on postoperative day 9.

A Study on the Effect of the Stemming Hole medium to the Blasting Separation Distance of Structure (공내 매질이 구조물의 발파이격거리에 미치는 영향에 관한 연구)

  • Kang, Hee-Seop;Jeong, Jung-Gyu;Bang, Myung-Seok
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.21 no.1
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    • pp.100-108
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    • 2017
  • Because of urbanization, Industrialization and expansion of transportation network, blasting works are recently increasing in construction field. The blasting work influences environmental effects to residents and the safety of facilities around the working place, so the development of blasting technology is needed to reduce the damage to residents. The blasting mechanism in the hole was studied and tested in the blasting sites by the difference of diameter between explosives and drilling hole, which is named by the decoupling effect. This effect was tested by changing the medium between explosives and hole wall in three working sites(railway, highway and industrial complex). The vibration velocity of blasting was recorded and vibration equations were produced by regression analyses. Finally, the structure separation distance was derived using these equations. The testing results show that the specific gravity of medium is larger, the separation distance is smaller and the duration time of blasting is shorter in case of large specific gravity of medium, so the vibration effect stops more fastly in the water compared with the air.

Esophageal Foreign Bodies with Periesophageal Abscess (식도주위농양을 병발한 식도이물 2례)

  • 김춘환;김주용;김영홍;강주원;김병우
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.9.3-9
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    • 1979
  • Foreign bodies in air and food passages are not uncommon problems in the otolaryngological fields and its etiological factors are closely related to the social environment and mode of life. It may complicate of esophageal perforation, periesphagitis, periesophageal abscess, mediastinitis, pneumothorax, pyothorax and lung abscess which may lead to the problems of life and death. The majority of esophageal foreign bodies which lodge in the esophagus can be removed endoscopically, but the following types of foreign bodies may require removal by the external route: 1. an impacted foreign body, 2. a foreign body producing periesophagitis after unsuccessful attempts at removal through the esophagoscope, and 3. a periesophageal abscess with a foreign body lodging in the abscess itself. Many interesting cases and statistical analysis of esophageal foreign bodies were reported by many authors, but only a few complicated cases were reported. Recently, we experienced 2 cases of esophageal foreign bodies which penetrate the cervical and thoracic esophageal wall and formed periesophageal abscess in 12 and 40 years-old males who swallowed of wire accidentally. The foreign bodies are successfully removed by the external routes through the lateral neck and chest. The postoperative courses were uneventful.

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A Clinical Manifestation of Meckel's Diverticulum (Meckel 게실의 임상양상)

  • Lee, Jin Beom;Lee, Yong Soon;Yoo, Eun Sun;Kim, Hae Soon;Son, Se Jeong;Park, Eun Ae;Lee, Seung Joo;Sung, Sun Hee;Seo, Jeong Wan
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.466-472
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    • 2002
  • Purpose : The diagnosis of Meckel's diverticulum is difficult and delayed because it presents with various clinical symptoms. We evaluated clinical, imaging and pathologic findings of Meckel's diverticulum to facilitate detection of Meckel's diverticulum in children. Methods : Review of clinical, imaging, surgical and pathological findings in 10 children aged 7 days to 14 years with Meckel's diverticulum during an 8-year period, 1993-2001, at Ewha Womans University Hospital was undertaken. Results : The male to female ratio was 2.3 : 1. The chief complaint was painless lower gastrointestinal( GI) bleeding; others were abdominal pain, abdominal distention and vomiting, in order of frequency. The diagonsis before surgery were Meckel's diverticulum in 5 patients, non-reducible intussusception in 3 patients and intestinal obstruction in 2 patients. The diverticulum was located between 35 cm to 70 cm proximal to the ileocecal valve. The length of the diverticulum ranged from 4 cm to 12 cm and 80% of it was within 5 cm. A Meckel scan($^{99m}Tc-pertechnetate$ scintigraphy) after cimetidine administration was done in 6 cases. All 5 cases that presented with lower GI bleeding had ectopic gastric mucosa confirmed on pathology. Out of 5 cases of ectopic gastric mucosa, only 4 cases were positive on the Meckel's scan. Conclusion : In cases of unexplained GI bleeding, obstruction, or inflammation diagnostic workup should be carried out to rule out Meckel's diverticulum. Laparoscopy, high resolution ultrasonography and computed tomography of the abdomen may be indicated in the assessment of pediatric patient with lower GI bleeding, especially in patients with suspected bleeding from Meckel's diverticulum showing negative Meckel's scan.

Ischemic Enterocolitis in Children (소아에서 발생한 허혈성 소장결장염)

  • Lee, Byung-Ky;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.138-146
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    • 2007
  • Purpose: Ischemic enterocolitis (IEC) is the total or partial infarction of the intestine in the absence of occlusion of a major mesenteric blood vessel. The purpose of this study was to evaluate the clinical features of IEC in children. Methods: A clinical analysis of 6 patients with IEC who were admitted to the Department of Pediatrics at Pusan National University Hospital, between 1996 and 2005 was conducted retrospectively. Patients were diagnosed with IEC based on clinical characteristics, including radiologic, endoscopic, histopathologic, and intraoperative findings. Results: Four boys and 2 girls between the age of 6 weeks and 6 years were included in this study. Most of the patients were born at term and had a birth weight that was appropriate for their gestational age. The major symptoms of IEC observed included hematochezia or hematemesis (5 cases), vomiting, diarrhea, abdominal pain or irritability (4 cases), as well as abdominal distension and fever (3 cases). IEC occurred in thecolon in 5 cases (2 descending colon, 1 descending and sigmoid colon, 1 sigmoid colon, 1 whole colon) and the duodenal bulb and gastric antrum in 1 case each. The type of the lesions observed includedulcera, which were found in 3 cases, perforation, which was pbserved in 2 cases, necrotic patches, which were observed in 2 cases, stricture, which was observedin 1 cases, and massive membranous desquamation of the epithelium, which was observed in 1 case. Two of the patients received surgical treatment and the remaining four were treated conservatively. None of the patients died. Conclusion: The presentation of IEC varies, and the findings of this study will be helpful in managing patients with IEC.

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Usefulness of early endoscopy for predicting the development of stricture after corrosive esophagitis in children (소아 부식식도염의 합병증 예측을 위한 조기 내시경 검사의 유용성)

  • Park, Ji Yong;Seo, Jeong-Kee;Shin, Jee Youn;Yang, Hye Ran;Ko, Jae Sung;Kim, Woo Sun
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.446-452
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    • 2009
  • Purpose : This study was performed to demonstrate the usefulness of early endoscopy for predicting the development of stricture following corrosive ingestion in children. Methods : We conducted a retrospective study on 34 children who were brought to Seoul National University Childrens Hospital and Seoul National University Bundang Hospital for corrosive ingestion from 1989 to 2007. Results : The corrosive burns were classified as grade 0 in 8 patients, grade 1 in 2, grade 2a in 7, grade 2b in 13, and grade 3 in 4. There was no significant correlation between the presence of esophageal injury and symptoms including vomiting, dysphagia, and drooling. There was a statistically significant relation between the presence of oropharyngeal injury and esophageal injury (P=0.014). There were no complications including hemorrhage and perforation related to endoscopy. Strictures of the esophagus or the stomach developed in 12 patients (36.4%). Esophageal stricture was observed in 11 patients and pyloric stenosis in 1 patient. The endoscopic grade of mucosal injury was significantly related to the frequency of development of esophageal stricture (P=0.002). Two of eleven patients with esophageal stricture responded to repeated dilation. The remaining seven patients underwent surgery. Conclusion : Early esophagogastroduodenoscopy is not only a safe and useful diagnostic tool for children with accidental caustic ingestion but also a necessity for determining the degree and the extent of caustic burns and for predicting the development of late complications.

Storage Quality of Early Harvested Satsuma Mandarin as Influenced by Hot Air Treatment (열풍처리에 따른 조생 온주감글의 저장 중 품질특성 변화)

  • Lee Hyun-Hee;Hong Seok-In;Son Seok-Min;Kim Dongman
    • Food Science and Preservation
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    • v.11 no.3
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    • pp.304-312
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    • 2004
  • Early harvested Satsuma mandarin (Citrus unshiu) was treated with hot air at 45$^{\circ}C$ for 2, 4, and 6 hours and stored at 5$^{\circ}C$ for 3 weeks and additional one week at 18$^{\circ}C$ (simulated shelf-life) in order to examine the effect of mild heat treatment on the storage quality of the citrus fruits. Quality attributes of the sample fruits evaluated during storage included the respiration rate, internal gas composition, pH, titratable acidity, soluble solids content, flesh weight loss, firmness, peel color, decay ratio, and sensory properties. The initial respiration rates, just after hot air treatment, were significantly higher in the heat-treated fruits compared to the untreated. However, during storage at 5$^{\circ}C$, the respiration rates showed a similar level in all treatments. Internal gas composition exhibited no significant difference between the heat-treated and untreated samples. Hot air treatment also exerted no significant effects on the pH, titratable acidity, soluble solid contents, flesh weight loss, firmness, and peel color of the fruits during the whole storage period. The decay ratio was manifestly lower in the heat-treated fruits than the untreated. For sensory attributes including visual and organoleptic quality, no significant difference was observed among sample fruits. Results suggested that mild heat treatment with hot air at 45$^{\circ}C$ for 4-6 hours could be used as an effective preconditioning method to keep the postharvest quality of Satsuma mandarin by reducing the decay incidence remarkably during storage.

Effect of Prophylactic Ibuprofen in Preterm Infants Less than 1,250 g in Birth Weight (1,250 g 미만 미숙아에서 예방적 Ibuprofen의 효과)

  • Yeo, Mun-Soo;Choi, Kyung-Vin;Lee, Hyun-Ju;Park, Hyun-Kyung;Kim, Chang-Ryul;Seol, In-Joon
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.234-239
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    • 2011
  • 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${\geq}$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.

Rotavirus-associated neonatal necrotizing enterocolitis (로타바이러스 감염이 관련된 신생아 괴사성 장염)

  • Seo, Hyun Joo;Jung, Yu Jin;Park, Soo Kyung;Choi, Seo Hui;Lee, Ji Hyuk;Kim, Myo Jing;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.56-60
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    • 2009
  • Purpose : This study aimed to test whether rotavirus-associated necrotizing enterocolitis (RV+NEC) produced different clinical findings or outcomes from those of non-rotavirus necrotizing enterocolitis (RV-NEC). Methods : Eight patients from the RV+NEC group and 22 patients from the RV-NEC group diagnosed with modified Bell stage II or higher NEC were selected for this study. Fecal specimens from all infants were tested for rotavirus infection using a monoclonal antibody-based enzyme immunoassay (EIA). Clinical, radiographic, and clinical outcome data were analyzed retrospectively. Results : RV+NEC infants had a significantly higher birth weight and were born at a significantly higher gestational age ($33.5{\pm}3.3$ weeks vs. $29.3{\pm}4.4$ weeks; P=0.01). There were no differences in the occurrence of thrombocytopenia, mural gas, and pneumoperitoneum between the 2 groups. However, portal vein gas was more common in the RV+NEC group (88% vs. 9%; P<0.01). Neither the incidence of Bell stage III (or higher) NEC nor surgical intervention differed between the two groups. The number of complications and mortality rates were also similar. Conclusion : Rotavirus-associated NEC occurs in infants with a higher birth weight and those born at a greater gestational age. However, the severity of the condition and the resulting outcomes did not differ from those for infants affected by non-rotavirus NEC.

Endoscopic Balloon Dilatation in Children with Congenital and Acquired Esophageal Anomalies (소아의 선천성 및 후천성 식도 질환에서 내시경적 풍선 확장술)

  • Kwak, Ju Yuong;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.137-142
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    • 2005
  • Purpose: To evaluate the safety, efficacy and technical problems of the endoscopic balloon dilatation of esophageal anomalies in children. Methods: The medical records of 8 children treated by endoscopic balloon dilatation for esophageal anomalies over a 10-year period at Pusan National University Hospital were reviewed retrospectively. The balloon catheter (Maxforce TTS or CRE, Boston Scientific Co., USA) was positioned across the area of narrowing by direct visualization. The balloon was slowly inflated with normal saline to specified pressures for each balloon and maintained for 60 seconds and then deflated. After 60 seconds pause, the procedure was repeated with a larger sized balloon (increments of 1 mm for each subsequent dilation) till effective dilatation was confirmed by direct visualization without complications. Results: Three male and five female were included and their mean age was 4.2 years. A total of 27 (average of 3.2 per patient) dilatation were performed. Underlying diseases of patients are postoperative stricture of esophageal atresia in 3 cases, esophageal ring in 2 cases, achalasia, corrosive esophagitis and hypertensive LES in one case respectively. The size of initial dilating balloon was chosen on the basis of the diameter of the narrowing determined by endoscopy. The first dilation in patients with severe esophageal stricture was made with a 6 mm sized balloon. Complications observed were esophageal perforation and respiratory holding during the procedure in one case respectively. Successful outcome was seen in 6 patients (75%). Conclusion: Endoscopic balloon dilatation can provide a safe and effective mean of treating esophageal anomalies in children and should be considered the treatment of choice in the initial management of those cases.

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