• Title/Summary/Keyword: A case report

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Portal vein reconstruction in pediatric liver transplantation using end-to-side jump graft: A case report

  • Jaewon Lee;Nam-Joon Yi;Jae-Yoon Kim;Hyun Hwa Choi;Jiyoung Kim;Sola Lee;Su young Hong;Ung Sik Jin;Seong-Mi Yang;Jeong-Moo Lee;Suk Kyun Hong;YoungRok Choi;Kwang-Woong Lee;Kyung-Suk Suh
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.3
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    • pp.313-316
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    • 2023
  • Attenuated portal vein (PV) flow is challenging in pediatric liver transplantation (LT) because it is unsuitable for classic end-to-end jump graft reconstruction from a small superior mesenteric vein (SMV). We thus introduce a novel technique of an end-to-side jump graft from SMV during pediatric LT using an adult partial liver graft. We successfully performed two cases of end-to-side retropancreatic jump graft using an iliac vein graft for PV reconstruction. One patient was a 2-year-old boy with hepatoblastoma and a Yerdel grade 3 PV thrombosis who underwent split LT. Another patient was an 8-month-old girl who had biliary atresia and PV hypoplasia with stenosis on the confluence level of the SMV; she underwent retransplantation because of graft failure related to PV thrombosis. After native PV was resected at the SMV confluence level, an end-to-side reconstruction was done from the proximal SMV to an interposition iliac vein. The interposition vein graft through posterior to the pancreas was obliquely anastomosed to the graft PV. There was no PV related complication during the follow-up period. Using a jump vascular graft in an end-to-side manner to connect the small native SMV and the large graft PV is a feasible treatment option in pediatric recipients with inadequate portal flow due to thrombosis or hypoplasia of the PV.

A Retrospective Study of 94 Hypercalcemic Dogs(2002-2004) (94 마리 고칼슘혈증 개들에 대한 회고연구(2002-2004))

  • Cho, Tae-Hyung;Kang, Byeong-Teck;Park, Chul;Jung, Dong-In;Yoo, Jong-Hyun;Kim, Ju-Won;Kim, Ha-Jung;Lim, Chae-Young;Lee, So-Young;Kim, Jung-Hyun;Woo, Eung-Je;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.479-485
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    • 2007
  • A retrospective study of 94 hypercalcemic dogs was performed to find out most common causes that lead to hypercalcemia through investigating dogs referred to the Veterinary Teaching Hospital of Konkuk University from 2002 to 2004. During the study period, hypercalcemia was found in 94 dogs of 19 breeds, and they were evaluated as case group. Control group was made up of 94 dogs of 18 breeds without hypercalcemia admitted for the same study period. For general signalments, there were no significant differences between case and control group with the exception of age distribution. Shih-tzu(17.02%) and Yorkshire terrier(26.60%) was the most common breed in case and control group, respectively. The most common diseases associated with hypercalcemia were chronic renal failure (18.09%), acute renal failure(14.89%), and renal calculi(6.38%). Malignant neoplasia(lymphoma, hemangiosarcoma, chronic lymphocytic leukemia, mammary gland tumor, and multiple myeloma) and endocrinopathies(hyperadrenocorticism, hyperthyroidism, hypoadrenocorticism, and hypothyroidism) occupied 8.5% and 6.4%, respectively. This report is a first retrospective study of hypercalcemic dogs in South Korea.

A Case of Child with Obstructive Sleep Apnea Syndrome Recurred after Adenotonsillectomy (편도 및 아데노이드 절제술 후 재발한 폐쇄성 수면 무호흡 증후군 소아 1례)

  • Kim, Cu-Rie;Kim, Dong-Soon;Seo, Hyun-Joo;Shin, Hong-Beom;Kim, Eui-Joong;Shim, Hyun-Joon;Ahn, Young-Min
    • Sleep Medicine and Psychophysiology
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    • v.15 no.2
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    • pp.94-99
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    • 2008
  • The most common cause of obstructive sleep apnea syndrome (OSAS) in childhood is adenotonsillar hypertrophy. Adenotonsillectomy improves the symptoms quite well in most cases. However, some patients could experience the OSAS again after adenotonsillectomy, who might have several risk factors such as incomplete operation, misdiagnosis, combined anatomical malformation, sinusitis or chronic allergic rhinitis, obesity, initial severe OSAS, and early onset OSAS. We report a case of 11-year-old obese boy who presented with snoring for several years. He was obese with body mass index (BMI) of $26.3kg/m^2$ and also found to have fatty liver by ultrasonogram. Initial polysomnography (PSG) showed that he met the criteria of severe OSAS with the apnea-hypopnea index (AHI) of 70.5. He underwent adenotonsillectomy and symptoms improved immediately. Four months later symptoms were relieved with AHI of 0, but 1 year after the adenotonsillectomy he started to complain snoring again and the subsequent PSG results showed that OSAS has relapsed with AHI of 43. Paranasal sinus X-ray and physical examination showed sinusitis and re-growth of adenoid. Obesity was proved not to be a contributing factor because his BMI decreased to normal range ($23.1kg/m^2$) after diet control and regular exercise. Also, liver transaminase was normalized and fatty liver was disappeared on follow-up abdominal ultrasonogram. After treatment of sinusitis, symptoms were relieved with decreased AHI (8.5). This case suggests that simple adenotonsillectomy might not be the end of OSAS treatment in childhood. Patients who had adenotonsillectomy should be followed by subsequent PSG if symptoms recur. It is also important to be aware of risk factors in the recurrent OSAS for the proper intervention according to the cause.

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A Case of Glycogen Storage Disease Type Ia Confirmed by Biopsy and Enzyme Assay (제Ia형 당원병 1례 (Glycogen Storage Disease , Type Ia))

  • Meen Sang-Ae;Rho Kwang-Sik;Kim Pyung-Kil;Jeong Hyeon-Joo;Park Young-Nyeon;Kim Myung-Joon;Kim Ji-Hong
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.77-81
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    • 1998
  • The author exprienced a case of glycogen storage disease type Ia(GSD-I) in an 18-year-old male patient who was admitted to our hospital due to proteinuria and hypertension. he was suspected to have GSD when 12 years old because of his family history of short stature and hepatomegaly. On admission, physical examination revealed short stature, heparomegaly, and The diagnosis of GSD-I was confirmed by compatible liver biopsy finding and enzyme assay which erealeddeficiency of glcose-6-phosphatase if hepatocyte. Sympromatic treatment was done using antihypertensive drugs and allopurinol with diet control. The authors report a case of glycogen storage disease type Ia completely confirmed by typical clinical manifestation, pathologic findings of the liver and the kidney, and the result of enzyme assay which revealed deficiency of glucose-6-phosphatase in hepatocytes with brief review fo related literatures.

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Development of Loop-mediated Isothermal Amplification (LAMP) for Detection of Vibrio alginolyticus (Loop-mediated isothermal amplification (LAMP)법을 이용한 Vibrio alginolyticus의 신속 진단법 개발)

  • Hong, Seung-hyun;Heo, Moon-Soo
    • Journal of Life Science
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    • v.25 no.8
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    • pp.903-909
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    • 2015
  • Loop-mediated isothermal amplification (LAMP), a PCR-based diagnostic method, is based on autocycling strand displacement DNA synthesis in the presence of exonuclease-negative Bst DNA polymerase under isothermal conditions. With the help of four specific primers that recognize six different sequences of a target DNA, LAMP has high specificity in pathogenic identification in a short time. Hence, in the present study, LAMP is used as a diagnostic tool in the identification of the most dreadful aquatic pathogenic species, Vibrio alginolyticus, and to develop species-specific LAMP primers and optimization of LAMP reaction conditions such as annealing temperature, elongation time, and other PCR chemical concentrations, including MgSO4, dNTPs, Betaine, and Bst polymerase. The optimized LAMP primers were also checked for specificity with other Vibrio species, which showed that the designed primers were very specific to V. alginolyticus After the first introduction of a species name like this one, the first part (“Vibrio” in this case) should be abbreviated to only the first letter.only. These are usually the most harmful pathogens of the Vibrio species that appear in shrimp and crabs. The results also revealed that the LAMP assay could be 10-fold more sensitive than conventional PCR in detecting V. alginolyticus. This could be the first report on using a rapid and highly sensitive technique, the LAMP assay, in the effective diagnosis of the pathogenic bacteria V. alginolyticus, which could help in the early detection of diseases, particularly in aquaculture.

A Case Study of Japanese Local Self-Governments Universal Design Policy (일본 자치체의 유니버설디자인 정책 사례연구)

  • Lee, Ho-Soong
    • Archives of design research
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    • v.19 no.1 s.63
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    • pp.27-38
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    • 2006
  • Recently, in each local self-governments Japan, the importation of universal design policy is actively being expanded as a plan to maximize living satisfaction of.citizens within the region. This research investigates the background on how the local self-governments ended up importing the universal design administrative policy, investigates the policies which each self governing bodies have been promoting and presents necessary stipulations following those policies. When we sum up the necessity of promoting universal design by local self-governments, although the we carry various problems in the promoting process in the settlement of provincial era and promoting substantiality of it, we can point out the low birth rate phenomenon, progression of aged people's society, diversification of values as a result of social and economic maturity, etc. as social and economic background. For people's values, as they escape from the economic they attach great importance to economic supremacy, they respect culture, environment, etc. with higher level than economic aspect and the improvement of life's quality is becoming important. Meanwhile, the universal design which is known to many users as a usable design concept as reach to a point where it is getting attention as a basic concept of 21st century design. Today, each of local self-governments in Japan are making various efforts for unperturbed importation and application of universal design to local communities through homepage, universal design guideline or report, various workshops, etc. Especially, there are universal design policies of public areas, facilities, manufacture of other products and information for the contents of the policy. The enforcement of universal design policy puts importance in 1) the process of planning, alteration, policy scheme and decision making 2) the process of policy's enforcement 3) the probation process of all processes and I could find out that equal participation of roles by local citizens, citizen's organizations, companies with the administration hasn't been adopted for each of these processes.

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Sevoflurane Insufflation Sedation for the Dental Treatment of a Patient with Pulmonary Arterial Hypertension : A Case Report (폐동맥 고혈압 환자의 치과치료에서 세보플루란 흡입 진정의 사용 : 증례보고)

  • Chi, Seongin;Kim, Seungoh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.1
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    • pp.75-79
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    • 2015
  • Pulmonary arterial hypertension (PAH) is a common complication of Congenital heart defects (CHD) with left-to-right shunts, and PAH with increased pulmonary vascular resistance (PVR) is associated with considerable morbidity and mortality. General anesthesia (GA) can be life-threatening in patients with PAH, because the positive pressure ventilation during GA increases pulmonary arterial pressure and decreases pulmonary blood flow. This may also lead to hypoxia. Therefore, spontaneous ventilation may be safer than positive pressure ventilation in patients with PAH. A five-year-old male child, weighing 11 kg, with medical history showing a total correction of Tetralogy of Fallot (TOF) in 2009 and ongoing treatment with hypertension (HTN) medicine since 2007, visited the Dankook University Dental Hospital. He had multiple dental caries, and the treatment was completed under sevoflurane insufflation sedation via nasal cannula. The patient remained sedated throughout the operation while maintaining normal vital signs and spontaneous respiration. In conclusion, sevoflurane insufflation sedation may be a safer alternative to GA for the dental treatment of patients with PAH.

Diagnosis and Management of Lymphoplasmacytic Rhinitis in a Cat (림포형질세포성 비염에 이환된 고양이의 진단과 치료)

  • Kang, Min-Hee;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.28 no.4
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    • pp.438-441
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    • 2011
  • A 7-year-old castrated, domestic shorthair cat was presented with a 2-year history of chronic nasal discharge and sneezing. Upon presentation, bilateral mucopurulent nasal discharge and stertorous respiration were marked. Physical examination revealed a tachypnea. Oral examination was unremarkable and chest radiology was normal. Findings of nasal cytology and skull radiology were not specific and further imaging technique, endoscopic examination and histopathology was performed for a definite diagnosis. Fluid, and/or soft tissue opacity was found in bilateral nasal cavity, nasopharyngeal regions and right side tympanic bulla through the CT scan. No evidence of neoplasia was revealed. A rigid rhinoscopy, flexible bronchoscopy and otoscopy was used for the visualization of the lesions and tissue biopsy biopsy was performed for histopathology. On histopathological examination, the nasal mass consisted mainly of large numbers of plasma cells and lymphocytes. And the final diagnosis was lymphoplasmacytic rhinitis based on histopathologic examination. Long term management with oral cyclosporine (5 mg/kg, BID) was safe and successful in this cat. This is the first case report described clinical and diagnostic characteristic features of feline lymphoplasmacytic rhinitis and its clinical outcome using oral cyclosporine in Korea.

Secondary Brain Tumor Caused by Infiltration of Nasal Neuroendocrine Carcinoma in a Chihuahua Dog: Clinical, Magnetic Resonance Imaging and Histopathological Findings (치와와견에서 발생한 비강 신경내분비암종의 침윤에 의한 이차적인 뇌종양 증례; 자기공명영상과 조직학적 특성)

  • Jung, Dong-In;Kang, Byeong-Teck;Kim, Ju-Won;Kim, Ha-Jung;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.27 no.2
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    • pp.186-189
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    • 2010
  • A 14-year-old neutered female Chihuahua was presented because of seizure episodes and circling to the left side. Based on neurological examination, the lesion was localized on left forebrain. The mass in the left nasal cavity and breaching of the nasal septum were seen magnetic resonance images. And there was a presence of contrast enhanced mass involving the rostral left brain. Based on diagnostic image analysis, this lesion strongly suggested secondary brain tumor infiltrated by nasal cavity. The patient's symptoms were well controlled by a combination therapy of prednisolone and lomustine (CCNU), and survived for two months after diagnosis. This case was definitively diagnosed as a nasal neuroendocrine carcinoma based on histopathological findings. This report describes the clinical findings, imaging characteristics, and pathologic features of secondary brain tumor which caused by infiltration of nasal neuroendocrine carcinoma in a dog.

Discussion of Exposure Evaluation Associated with Extremely Low Frequency-magnetic Field in the Case of Portable Hand-held Fans (휴대용 손 선풍기의 극저주파 자기장 발생 수준 평가와 쟁점 고찰)

  • Park, Dong-Uk;Yi, Seongjin;Kim, So-Youn;Bae, Seo-Youn;Choi, Sangjun;Kim, Won;Min, Sung Hyon;Park, Jihoon;Ahn, Jongju
    • Journal of Environmental Health Sciences
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    • v.44 no.5
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    • pp.480-490
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    • 2018
  • Objective: This study aimed to report the level of extremely low frequency-magnetic field (ELF-MF) emitted by portable hand-held fans (HHF) and to discuss the methodologies for determining the health risk of ELF-MF for HHF products. Method: ELF-MF was monitored at eight locations by distances in the vicinity of HHFs. A total of 13 HHF brands on the market were randomly selected. A portable ELF-MF monitor MDEX II was used to measure the ELF-MF level in the range of 40-800 Hz with a resolution of $0.01{\mu}T$. This study also examined the frequency results of a total of 45 HHF products investigated by the Korean Ministry of Science and ICT (KMSICT). Results: ELF-MF higher than $0.3{\mu}T$ was found to be emitted at a distance of less than 20 cm from 12 HHF. ELF-MF emitted from four products was found to exceed the reference level ($83.3{\mu}T$ based on 60 Hz) recommended by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). KMSIT reported that the principle frequency emitted from the HHFs ranged from 54 Hz to 284 kHz, without the level of LEF-MF. Unscientifically, the KMSICT used the reference level by ICNIRP as the chronic level and concluded that all HHFs are safe with a basis of 1.2-36.0% less than the reference level. Conclusion: The HHF emitted much higher levels of ELF-MF than $0.3-0.4{\mu}T$, which is regarded as the reference level for childhood leukemia. The risk of HHF should be examined in terms of whether they can be used by the general public, including children and pregnant woman.