• Tuberculosis and Respiratory Diseases
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• v.51 no.6
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• pp.585-589
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• 2001

Pneumoperitoneum, Pneumomediastinum, subcutaneous emphysema and a pneumothorax are some of the mechanical complications of bronchial asthma. The incidence of pneumoperitoneum during an attack of acute asthma is rare. The pathogenesis is free gas track from the overdistended alveoli, through the bronchovascular sheaths to the mediastinum. If the high pressure is maintained, air can escape retroperitoneally into the abdomen and burst into the peritoneal cavity. A 43-year-old woman was admitted due to a severe asthma attack. She was required endotracheal intubation and AMBU(air mask bag unit) ventilation. Immediately after these procedures, pneumoperitonewn, pnewnomediastinwn, and subcutaneous emphysema developed. She was treated with mechanical ventilation and medical therapy. The pneumoperitonewn was resolved after 27days. Here, we report this case with the review of the relevant literature.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.1
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• pp.57-62
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• 2019

Purpose: This study was performed to assess the clinical usefulness of transabdominal ultrasonography (TUS) in detecting peptic ulcer disease (PUD) in children. Methods: Twenty-four patients (19 boys, 5 girls; mean age, $10.6{\pm}4.5years$ [range, 3.0-17.9 years]) who were admitted to the hospital for acute abdomen or gastrointestinal bleeding and diagnosed with PUD by endoscopy and who underwent TUS were included. Clinical data were retrospectively collected by reviewing patient medical records. Gastric ulcer (GU) was suspected when the gastric wall exceeded 8 mm in thickness and had lost its five-layer structure on TUS. Duodenal ulcer (DU) was suspected if the duodenal wall thickness exceeded 5 mm. Results: Sensitivity of TUS in diagnosing PUD was 66.7% for GU and 38.9% for DU. Mean age and body weight of the 11 patients suspected with PUD on TUS were $10.9{\pm}4.4years$ and $38.1{\pm}17.2kg$, respectively. For 13 patients without suspected PUD, they were $12.1{\pm}4.1years$ and $39.6{\pm}17.0kg$, respectively. There was a significant difference in height, weight, and body mass index between patients who were suspected to have PUD and those who were not suspected on TUS (p=0.014, 0.008, and 0.005, respectively). A significant difference in the sensitivity of TUS in diagnosing PUD was found between patients under 30 kg and those over 30 kg (88.9% and 20.0%, respectively; p=0.003). Conclusion: TUS investigation of the stomach and duodenum is an efficient method for PUD detection in children with low body weight. TUS can be used in preliminary diagnostic work-up before further invasive tests.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.3
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• pp.279-287
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• 2021

Purpose: The clinical implications of bowel wall thickening (BWT) on abdominal computed tomography (CT) among children are unknown. We aimed to suggest a new method for measuring BWT and determining its clinical significance in children. Methods: We retrospectively analyzed 423 patients with acute abdomen who underwent abdominal CT; 262 were classified into the BWT group. For this group, the pediatric radiologist described the maximal bowel wall thickness (MT), normal bowel wall thickness (mm) (NT), and their ratios for each segment of the bowel wall. Results: In the thickened bowel walls, the thickness differed significantly between the small bowel (6.83±2.14 mm; mean±standard deviation) and the colon (8.56±3.46 mm; p<0.001). The ratios of MT to NT in the small bowel (6.09±3.17) and the colon (7.58±3.70) were also significantly different (p<0.001). In the BWT group, 35 of 53 patients had positive fecal polymerase chain reaction results; 6 patients infected with viruses predominantly had BWT in the small intestine, while the terminal ileum and the colon were predominantly affected in 29 patients with bacterial infections. In the initially undiagnosed 158 patients with BWT, the symptoms improved spontaneously without progression to chronic gastrointestinal disease. Conclusion: This study provides a clinical reference value for BWT in the small intestine and colon using a new method in children. The BWT on abdominal CT in children might indicate nonspecific findings that can be observed and followed up without additional evaluation, unlike in adults.

• 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.

• Journal of Veterinary Clinics
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• v.22 no.4
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• pp.450-452
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• 2005

A 3-year-old, 43kg, pregnant Great Pyrenese was examined for clinical signs of acute weakness and anorexia for 4 days. The dog was in lateral recumbency at referral. The rectal temperature was within reference range, and the respiratory and heart rates were 36 breaths/min and 58 beats/min, respectively. The abdomen was distended, and several puppies were palpated. The mean fetal head diameter was 2.8cm in the ultrasonographic examination. The initial complete blood count and serum biochemical examinations revealed mild dehydration, mud hyperglycemia, hypochloremia, hyperkalemia, hyponatremia, and low sodium-potassium ratio. Serum BUN and total cholesterol values were slightly high. Hypoadrenocortical crisis was suspected on the basis of signs of acute collapse, hyponatremia and hyperkalemia. Adrenal gland function was evaluated by an ACTH stimulation test. The baseline cortisol concentration was $18.6{\mu}g/dl$ and the concentration at 1 hour after administration of tetracosactrin (ACTH, Synacthen) was $8{\mu}g/dl$. The dog was treated for the correction of assumed hypoadrenocortical crisis and substantial hyperkalemia. In addition to rapid infusion with saline solution, other medications administered intravenously included sodium bicarbonate and cimetidine hydrochloride. The dog was monitored with repeated serum electrolyte examination. After clinical stabilization, cesarean section was performed. All of 13 puppies were delivered, and the dog recovered from anesthesia without complications. The values of postpartum blood tests returned to normal or within reference range. The dog remained healthily.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.8 no.1
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• pp.131-132
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• 1995

After studing of viewpoint of surgical disease in seven medical books related with Ju Dan Gye(朱丹溪) among four eminent physicians in the Jin and Yuan dynasties(金元四大家) I get conclsion as following. 1. Studied surgical diseases are total 40 kinds. 2. In 40 kinds surgical diseaes, case of having theory are 20 kinds, cases of having no theory and having only treatement by medicine are 20 kinds. 3. In therapy, cases that mainly use a method to eliminate pathogenic factors are 27 kinds; Acute mastitis(乳癰), Deep-seated mammary abscess(내巖), Acute appendicitis(陽癰), Bone cellulitis(附骨疽), Carbuncle of the lower abdomen near external genitalia(便毒), Leprosy(癩風), Macule(斑), Rash(疹), Urticaria(은疹), Scrofula(나역), Stagnant plegm(結核), Goiter andtumer(영유), Erysipelas(丹), Furuncle(정瘡), Scabies(疥瘡), Chancre(下疳瘡), Syphilitic skin disease(樣梅瘡), Incised wound (金瘡), Dermatopathy of lower limb and heel(脚足部瘡), Pemphigus(天疱瘡), Itching eruption due to blood-heat or wind heat(血風瘡), Dermatopathy of head(頭面瘡), Scald and burn(湯火瘡), Tetanus(破傷風) , Ecthyma(염瘡), Fistula(久漏瘡), Tinea(癬瘡), Cases that mainly use external therapy are 5 kinds; Rhagades of hand and foot(手足군裂), Vulvar ulceration(婦人陰瘡), Chilblain(凍瘡), Rabies(풍狗咬), Tinea capitis(白禿瘡), Cases that mainly use a reinforcing method are 4 kinds; Internal deep-rooted carbuncle(內疽), Pruritus and dryness of skin(皮膚乾燥), Anul fistula(漏瘡), Macule Caused by disorder of internal organ(內傷發斑), Cases that mainly use eliminating first and then reinforcing are 2 kinds; Pyogenic infection and ulcerous disease of slin( 疽瘡상癰疽瘡瘍), Lung abscess(肺癰), Case that mainly uses reinforcement and elimination in combination is only Haemorroid(痔瘡). Case divided into two groups that are reinforcing method and a method to eliminate pathogenic factor is only Trauma(打撲). Case that have no treatment by medicine is only Abscess of the scrotum(囊癰). 4. In 40 kinds surgical diseases, we can know that except a few important surgical diseases, Ju Dan Gye haven't distinguished viewpoint in many surgical diseases, because there are many cases that have no theory and have only simple treatment of medicine, and that mainly use a method to eliminate pathogenic factors and external therapy. 5. Representative theory of Ju Dan Gye, nourishing Yin and extinguishing fire(滋陰降火), has little effect on therapy of surgical disease. We need to try statistical division of internal and external remedy in the future, and by studing of surgical disase in medical books related with four eminent physicians in the Jin and Yuan dynasties, I think we can see their viewpoint of surgical disease.

• Clinical and Experimental Pediatrics
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• v.46 no.6
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• pp.576-584
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• 2003

Purpose : For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. Methods : The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. Results : The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastrointestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum( 21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. Conclusion : The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.

• The Journal of Pediatrics of Korean Medicine
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• v.32 no.3
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• pp.100-118
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• 2018

Objectives The purpose of this study is to analyze some of the TCM (traditional Chinese medicine) clinical research literatures about pediatric night crying in order to learn clinical application of Korean medicine treatment for pediatric night crying. Methods We searched clinical trial literatures about TCM treatment of pediatric night crying from the CNKI (China National Knowledge Infrastructure) (January 2000 to June 2018). We analyzed the literature in regards to the treatment methods and the results. Results Among the 459 searched studies, 13 randomized controlled trials and 41 case studies were selected and analyzed. In most of the studies, the effectiveness of TCM in treating patients was significantly high, so we confirmed the effectiveness of TCM on pediatric night crying. The most commonly used pattern differentiations (辨證) were Spirit damage due to fright and fear (驚恐傷神), Spleen deficiency and cold (脾虛寒) and Heart fire heat (心火熱). Methods of treatment include herbal medicines (internal medicine and external application), massage therapy (Tuina methods), acupuncture and other treatments (bloodletting). The most commonly used herb medicines were Cicadidae Periostracum (蟬?), Poria Cocos (茯?), Glycyrrhizae Radix (甘草), Uncariae Ramulus et Uncus (釣鉤藤), Junci Medulla (燈心草), Fossilia Ossis Mastodi (龍骨), Atractylodis Rhizoma Alba (白朮), Cinnabaris (朱砂), and Coptidis Rhizoma (黃連). The most commonly used massage methods were Clearing Liver Channel (淸肝經), Clearing Heart Channel (淸心經), Kneading $Xi{\check{a}}oti{\bar{a}}nx{\bar{i}}n$ (?小天心), Supplementing Spleen Channel (補脾經), Clearing $Ti{\bar{a}}nh{\acute{e}}shu{\check{i}}$ (淸天河水), and Rubbing Abdomen (摩腹). Conclusions Based on the results of clinical studies from China, the use of Korean medicine for the treatment of pediatric night crying has been shown to be effective in relieving symptoms. Based on the results of this study, it is possible to widen the scope of Korean medicine by additionally reviewing clinical and experimental studies on pediatric night crying.

• Journal of Veterinary Clinics
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• v.32 no.5
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• pp.399-403
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• 2015

Peritoneal dialysis (PD) is a treatment for renal failure and acute poisoning, and uses the patient's peritoneum in the abdomen as a membrane across which fluids and dissolved substances are exchanged from the blood. In this study, we evaluated the therapeutic efficacy and complications of automated peritoneal dialyzer (APD) in dogs with renal failure. PD was performed in 10 dogs using a swan neck catheter (Neonatal, Coviden) and automatic APD. The efficacy for each dog was assessed by calculating urea reduction ratio (URR) and creatinine reduction ratio (CRR). Mean concentrations of pre-dialysis creatinine and blood urea (BUN) were $7.09{\pm}3.84$ and $145.8{\pm}48.5$, respectively. The mean number of peritoneal dialysis cycles applied was $6{\pm}1$ cycles. Peritoneal dialysis resulted in a significant decrease in BUN concentration in 7/10 dogs, while a significant decrease in creatinine concentration in 9/10 dogs. The mean of URR was higher than that of CRR ($0.39{\pm}0.16$ vs $0.38{\pm}0.13$). The mean CRR and URR per dialysis cycles were $0.064{\pm}0.023$ and $0.065{\pm}0.023$, respectively. Complications found in this study were catheter occlusion, subcutaneous dialysate leakage, septic peritonitis, hypoalbuminemia and overhydration. This study found PD using a swan neck catheter and APD machine showed acceptable efficacy for successful peritoneal dialysis in dogs. However, close monitoring is required to minimize the risk of complication.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.1005-1009
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• 1997

Diaphragm injuries are very important because, if both thoracic and abdominal viscera are damaged, a combination of shock and acute respiratory distress may develop. It can be highly lethal. This evaluation was based on the reviews of 17 cases of traumatic diaphragm injuries treated at the Department of Cardiovascular Surgery, Seoul Adventist Hospital during 5 years from March 1993 to February 1997. The mean age of the patients was 37.2 years and sex ratio was 3.2:1 with male dominance. Blunt trauma(N=5, Rt.=4, Lt.= 1) was 29.5%, penetrating trauma(N= 12, Rt.=5, Lt.=7) was 70.5%. Dyspnea(76%) was the most common symptom. Blunt trauma(9.8$\pm$3.7 Cm) was larger than the penetrating trauma(3.2$\pm$ 1.3 Cm)(P<0.05) in the size(mean$\pm$SD) of the injury. All of the patients had associated injuries and repaired immediatley with thoracic approach 11 cases(64%), abdominal approaih 3 cases(18%) and thoracoabdominal approach 3 cases(18%). f cases of penetrating diaphragmatic t auma was diagnosed on the operation of other organ injury Now we suggest that diaphragmatic injury should be suspected in all patients with penetrating as well as blunt injury of the chest and abdomen to protect the patient from its late complications.