• Journal of Trauma and Injury
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• v.36 no.3
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• pp.165-171
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• 2023

Trauma remains a significant healthcare burden, causing over five million yearly fatalities. Notably, the liver is a frequently injured solid organ in abdominal trauma, especially in patients under 40 years. It becomes even more critical given that uncontrolled hemorrhage linked to liver trauma can have mortality rates ranging from 10% to 50%. Liver injuries, mainly resulting from blunt trauma such as motor vehicle accidents, are traditionally classified using the American Association for the Surgery of Trauma grading scale. However, recent developments have introduced the World Society of Emergency Surgery classification, which considers the patient's physiological status. The diagnostic approach often involves multiphase computed tomography (CT). Still, newer methods like split-bolus single-pass CT and contrast-enhanced ultrasound (CEUS) aim to reduce radiation exposure. Concerning management, nonoperative strategies have emerged as the gold standard, especially for hemodynamically stable patients. Incorporating angiography with embolization has also been beneficial, with success rates reported between 80% and 97%. However, it is essential to identify the specific source of bleeding for effective embolization. Given the severity of liver trauma and its potential complications, innovations in diagnostic and therapeutic approaches have been pivotal. While CT remains a primary diagnostic tool, methods like CEUS offer safer alternatives. Moreover, nonoperative management, especially when combined with angiography and embolization, has demonstrated notable success. Still, the healthcare community must remain vigilant to complications and continuously seek improvements in trauma care.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.433-439
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• 1996

From January 1980 to July 1995, 32 patients with blunt diaphragmatic trauma and 12 wish penetrating diaphragmatic trauma were treated at Kyungpook University Hospital. The mean age of patients with blunt trauma was 37.6 years, and with penetrating trauma 29.2 years. The mean age was older in patients with blunt trauma by 8.4 years (p< 0.05). When simple chest X-ray diagnosis was performed, 24cases (75%) of the diaphragmatic injuries were found in blunt trauma and 4 case(33%) in penetrating trauma. When opei.ations were done due to injuries of thoracic or abdominal organ, 7 diaphragmatic injuries (58%) were found in penetrating trauma. Herniation occurred in 24 patients (75%) in blunt trauma and 5 patients (42%) in penetrating truma. The size of injured diaphragms in 29 cases in which hernia was discovered was 10.9 $\pm$ 4.3cm. On the other hand, the size in 15 cases in which hernia did not occur was 3.5 $\pm$ 2.9cm. There was a remarkable difference in their size depending on the presence or absence of hernia (p< 0.051. That is, a close relation between the sire of injured diaphragms and hernia was shown. All diaphragmatic injuries were repaired primarily. In blunt trauma approach of repair were as follows : 20 (63%) thoracic, 9 abdominal, 2 thoracoabdominal, and 1 thoracic and in penetrating trauma 6 (50%) abdominal, 4 thoracic, and 2 thoracic and abdominal. The complication rate was 19% in blunt trauma and 25% in penetrating trauma. Two patients with blunt trauma died with a mortality rate of 6.3% . All patients with penetrating trauma recovered. This study suggests that diaphragmatic injury should be suspected in all patients w th blunt as well as penetrating injury of the chest and abdomen. The size of injured diaphragms was larger in blunt trauma than in penetrating trauma. For herniation, it appeared to be more common in blunt trauma. The morbidity and mortality were related primary to the severity of associated injuries.

• The Journal of the Korea Contents Association
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• v.20 no.10
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• pp.411-423
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• 2020

The purpose of this study was to examine the association between metabolic syndrome and its components and health-related quality of life in Korean adults. Metabolic syndrome defined in accordance with NCEP-ATP III, and HRQOL was evaluated using EQ-5D. Data on 16,657 adult, extracted from Korean National Health and Nutrition Examination Surveys in 2016-2018, were analyzed and showed that 34.3% of subjects were metabolic syndrome, with males higher than females. The average score of HRQOL was 96.7 for men and 94.5 for women. Multiple logistic regression analysis was results, The OR of impaired HRQOL in women who metabolic syndrome was 1.27(95% CI: 1.09-1.46) compared to who women without metabolic syndrome. Among the components of metabolic syndrome, abdominal obesity (OR=1.72, 95% CI: 1.50-1.97) and high blood pressure (OR=1.26, 95% CI: 1.06-1.50) were associated to impaired HRQOL. But, there were no significant in men. In conclusion, In order to improve women's HRQOL, it suggests that an approach strategy is necessary to reduce the risk factors of metabolic syndrome, which take into account women's characteristics.

• Advances in pediatric surgery
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• v.17 no.1
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• pp.65-71
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• 2011

Currarino syndrome is a hereditary syndrome characterized by the triad of a sacral bony defect, presacral mass and anorectal malformation. We retrospectively reviewed 13 Currarino syndrome patients who were treated in our center between 1997 and 2010. Demographic data, initial symptoms, initial diagnosis. pathologic diagnosis of presacral mass, associated anomalies and managements were analyzed. There were 8 boys and 5 girls. Four patients were diagnosed as Currarino syndrome immediately after birth with failure of passage of meconium and abdominal distension. Four patients underwent surgery for imperforate anus immediately after birth and W8re diagnosed as Currarino syndrome later and underwent reoperation. Three patients were diagnosed during work-up and management with of the tentative diagnosis of Hirschsprung's disease. Diagnosis of the remaining two patients was at the age of 26 months and 9 years and anorectal malformation was not associated. Twelve patients showed hemi-sacrum and one patient showed bilateral sacral subtotal agenesis. Two patients without anorectal malformation underwent presacral mass excision, untethering of spinal cord and repair of myelomeningocele. Six out of 8 patients, excluding 3 that expired or were lost to follow up, with anorectal malformation underwent colostomy, presacral mass excision, untethering of spinal cord, repair of myelomeningocele, posterior sagittal anorectoplasty and colostomy repair. One patient underwent only posterior sagittal anorectoplasty after colostomy. One waits the scheduled operation only with Hegar dilatation. Pathologic examation of presacral masses showed myelomeningoceles in 4 patients, lipomyelomeningoceles in 3 patients and dermoid Cyst in one patient. Teratoma was combined in 2 patients. Eight patients needed neurosurgical operation for spinal cord problems. Seven patients had urologic anomalies and two of them underwent operation. Currarino syndrome should be considered as a differential diagnosis in pediatric patients with abdominal distension, constipation and anorectal malforlnation. For proper evaluation and treatment, a multi-disciplinary approach is recommended.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.217-222
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• 2012

Purpose: Diaphragmatic rupture following trauma is often an associated and missed injury. This report is about our experience with treating traumatic diaphragmatic rupture (TDR). Methods: From January 2007 to September 2012, 18 patients who had a diaphragmatic rupture due to blunt trauma or penetrating injury underwent an operation for diaphragmatic rupture at our hospital. We retrospectively reviewed their medical records, including demographic factors, initial vital signs, associated injuries, interval between trauma and diagnosis, injured side of the diaphragm, diagnostic tools, surgical method or approaches, operative time, herniated organs, complications, and mortality. Results: The average age of the patients was 43 years, and 16 patients were male. Causes of trauma included motor vehicle crashes (n=7), falls (n=7), and stab wounds (n=5). The TDR was right-sided in 6 patients and left-sided in 12. The diagnosis was made by using a chest X-ray (n=3), and thorax or upper abdominal computed tomography (n=15). Ten(10) patients were diagnosed within 12 hours. A thoracotomy was performed in 8 patients, a video-assisted thoracoscopic surgery in 4 patients, a laparotomy in 3 patients, and a sternotomy in one patient. Herniated organs were the omentum (n=11), stomach (n=8), spleen and colon (n=6), and liver (n=6). Eighteen diaphragmatic injuries were repaired primarily. Seven patients underwent ventilator care, and two of them had pneumonia and acute respiratory distress syndrome. There were no operative mortalities. Conclusion: Early diagnosis and surgical treatment determine the successful management of TDR with or without the herniation of abdominal organs. The surgical approach to TDR is chosen based on accompanying organ injuries and the injured side.

• Advances in pediatric surgery
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• v.17 no.2
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• pp.154-161
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• 2011

Tracheoesophageal fistula without esophageal atresia (H-type TEF) is a congenital anomaly that is characterized by a fistula between the posterior wall of the trachea and the anterior wall of the esophagus, not accompanied by esophageal atresia. The purpose of this study is to investigate the clinical characteristics, diagnostic time, the side of cervical approach and short term result after surgery by searching medical records of patients treated for H-type TEF. The search was done at University of Ulsan, Department of Pediatric Surgery of Asan Medical Center, and the total number of patients from May 1989 to December 2010 was 9 with M:F ratio of 1:2. The median gestational age was $39^{+6}$ ($32^{+6}{\sim}41^{+0}$) wks. Seven out of nine patients were born at term and the other two were born premature. The clinical presentation was aspiration pneumonia, difficulty in feeding, chronic cough, vomiting, abdominal distension and growth retardation. The symptoms presented right after birth. The diagnosis was made with esophagography and the median time of diagnosis was 52 days of life. The majority of surgical corrections were performed within two weeks of diagnosis (median; 15d, range; 1d - 6m). Six patients had associated anomalies, and cardiac anomalies were most common. The cervical approach was utilized in all cases (right 2, left 7). Transient vocal cord palsy and minor esophageal leakage complicated two cases. Although the diagnosis of H-type TEF was difficult and often delayed, we had a good short term result. The left cervical approach was preferred.

• Food Science of Animal Resources
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• v.30 no.1
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• pp.87-94
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• 2010

The aim of the present study was to develop polyclonal antibodies to regional inedible adipocytes of pigs and investigate the effect of these antibodies on adipocytes in vitro. As antigens, abdominal and subcutaneous adipocyte PMPs from pigs were injected into sheep 3 times per 3 wk intervals for passive immunization, and non-immunized serum, antisera against abodominal (AAb) or subcutaneous adipocyte PMPs (SAb) were collected before and after the injections. Titers of the antisera obtained from sheep and their cross-reactivities with the heart, kidney, liver, lung, muscle, and spleen of pig were determined by ELISA. Isolation and culture of abdominal and subcutaneous adipocytes from pigs were performed to analyze LDH concentration. At a 1:1,000 dilution, little antibody reactivity was observed for non-immunized serum whereas both AAb and SAb had relatively strong reactivity up to a dilution of 1:16,000. These findings may indicate that strong antibodies against adipocyte PMPs can be developed using an immunological approach. Extremely low reactivity of AAb and SAb was detected with the PMPs of the organs. Both antisera most strongly reacted with each adipocyte PMPs and showed statistically (p<0.05) higher cross-reactivities compared with the non-immunized serum. In conclusion, these results may indicate that the present polyclonal antibodies against regional inedible adipocyte PMPs are well developed and are safe against cross-reactivities with the organs of pigs. Further studies on the in vivo nutritional safety and fat reduction of these antibodies in pigs will be required fat-reduced high quality pork production.

• 한국생물공학회:학술대회논문집
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• 2003.04a
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• pp.98-100
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• 2003

Synthetic polymers such as PET and ePTFE have widely been used for artificial vascular patches. However, these materials cannot function for a long term as blood vessel due to thrombotic occlusion and calcification. To overcome this limitation, a biocompatible vascular patch was developed using stem cell and tissue engineering approach. Autologous bone marrow mesenchymal stem cells were differentiated into vascular endothelial cells and smooth muscle cells. These cells were seeded onto collagen patch matrices. The matrices were anastomosed to abdominal arteries in canine models. Prior to implantation, histological and scanning electron microscopical examination revealed stem cell adhesion and growth on the matrices. At 3 weeks, the implanted vascular patches were patent. Histological examination showed the regeneration of endothelium, media and adventitia in the grafts. Cell tracing analysis using fluorescent reagent showed that labeled stem cells were present in the implanted grafts and contributed to the regeneration of vascular tissues. This study may help us develop a tissue-engineered vascular patch appropriate for clinical applications.

• Journal of Chest Surgery
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• v.7 no.2
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• pp.163-168
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• 1974

Five cases of traumatic diaphragmatic hernia were repaired in the Department of Thoracic Surgery, Seoul National University Hospital, during the period from 1967 to 1974. The first case, a 14-year aid girl, was diagnosed as diaphragmatic hernia during laparotomy because of jejunal perforation 3 days after traffic accident. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture on left posterolateral portion was repaired with two layers of nonabsorbable sutures by transthoracic approach. The second case, a 26-year old man,was diagnosed immediately after traffic accident at a local clinic and transferred to this hospital 24 hours later. Herniated stomach, transverse colon and jejunum were repositioned amd diaphragmatic rupture,about 9 cm in length,from the posterolat.edge to the base of pericardium was sutured in two layers. The third case, a 26-year old man who had stab wound on the left lower lateral chest two years ago,was admitted with sudden abdominal pain and vomiting. Upper gastrointestinal series with barium meal revealed diaphragmatic hernia. The herniated stomach and transverse colon through the defect,about 3.5cm in diameter, at anterolateral portion on the left side,were repositioned and repaired with two layers of nonabsorbable sutures. The forth case, a 26-year old man, sustained blunt trauma to the chest by a roller and was transferred to the emergency room complaining of dyspnea 40 minutes after the accident. The diaphragmatic rupture extended from left midaxillary line to contralateral anterior axillary line,about 20cm long, at anterior portion of diaphragm, which was repaired with two layers, of nonabsorbable sutures. The fifth case, a 4-year old girl, had two separate diaphragmatic ruptures on both sides, which were caused by traffic accident. Immediate upper gastrointestinal series after injury showed herniated stomach, colon and spleen into left Chest cavity. Another small rupture with anterior edge of right lobe of the liver in chest cavity was noted. These were repaired with non-absorbable sutures via thoracotomy.

• The Journal of Internal Korean Medicine
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• v.21 no.1
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• pp.162-168
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• 2000

Irritable Bowel Syndrome(IBS) is the most common disease in the western male, and it is founded in $70{\sim}80%$ patient who has Gastrointestinal trouble. It is characterized by the formation of disorders of Gastrointestinal tract, for example, constipation, diarrhea, abdominal pain& discomfort, stool urgency, and so on. The etiology of IBS is uncertain, but the majority of patients has emotional problems. The aims of this study are to investigate and summarize the current trends of treatment for IBS so as to suggest the effective and available way to treat this disease. In Oriental Medicine, the IBS is recognized as Stagnation of the Iiver-qi(肝氣鬱結), Incoordination between the liver and the stomach(肝胃不和). So the point of treatment of IBS is Invigorating the spleen and relieving the depression of Iiver-qi(疏肝健脾), Regulating the function of the liver and the flow of qi(調肝理氣), Regulating the stomach and lowering the adverse flow(和胃降逆), and the treatment can be approached in several ways through herb drugs, acupuncture. Some of the herb drugs have substances which promote gastric and small intestinal emptying. Acupuncture and moxibustion therapies stimulate the meridian points of LR(足厥陰肝經), ST(足陽明胃經), LI(手陽明腸經), SI(手太陽小腸經) and is reported to be effective for releafing syndromes. Anal therapy, attachment of herb drug to umbilicus are annunced as the effective treatments. So, this study of the approach and application of these treatments on IBS would be necessary.