• Journal of Yeungnam Medical Science
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• 제30권1호
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• pp.39-42
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• 2013

Cholelithiasis, duodenal ulcer, duodenal perforation and tumor invasion may lead to choledochoduodenal fistula (CDF). CDF often has no specific symptoms and may be incidentally detected in an upper gastrointestinal radiographic study or endoscopy; but in some cases, it may be accompanied by recurrent cholangitis and liver abscess. In this paper, a case of recurrent liver abscess caused by CDF is reported. A 62-year-old female was admitted to the authors' hospital because of right upper quadrant pain and fever. The abdominal computed tomography showed a liver abscess in the right lobe. A duodenal fistulous orifice was detected with endoscopy, and a contrast was injected through the duodenal orifice using a catheter under fluoroscopy. The injection of the contrast revealed a fistulous track between the duodenal bulb and the common hepatic duct. In fistulas complicated by recurrent liver abscess, surgery or medical management may be needed. The CDF in this case study was treated via endoscopic clipping.

• Journal of Korean Neurosurgical Society
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• 제44권3호
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• pp.170-173
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• 2008

Ventriculoperitoneal (VP) shunt is commonly and effectively used to treat hydrocephalus. Intracardiac migration of the shunt catheter is a rare complication. A 68-year-old woman underwent ventriculoperitoneal shunting for hydrocephalus secondary to subarachnoid hemorrhage due to anterior communicating artery aneurysm rupture. Two weeks after the shunt surgery, she had suffered from the abdominal pain. Plain chest x-rays, computed tomography, and echocardiography revealed the distal catheter which was in the right ventricle of the heart. We tried to remove the catheter through the internal jugular vein by fluoroscopic guidance. But, the distal catheter was kinked and knotted; therefore, we failed to withdraw the catheter. After then, we punctured the right femoral vein and pulled down the multi-knotted shunt catheter to the femoral vein using the snare catheter. Finally, we removed the knotted distal catheter via the femoral vein and a new distal catheter was placed into the peritoneal cavity. We report a case in which the distal catheter of the VP shunt migrated into the heart via the internal jugular vein. We emphasize the importance of careful and proper placement of the distal catheter during the tunneling procedure to prevent life-threatening complications.

• The Korean Journal of Pain
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• 제7권2호
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• pp.282-286
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• 1994

The central antihypertensive agent clonidine is an ${\alpha}_2$-adrenergic agonist that possesses pain-relieving properties. It has been administered epidurally in the treatment of cancer pain and for postoperative analgesia. 1) Case 1, 62-year-old woman who suffered from neurogenic pain syndrome due to metastatic squamous cell carcinoma of spinal canal was treated. 2) Case 2, 51-year-old woman undergoing lower abdominal surgery, epidurally administered morphine did not produced postoperative analgesia. In these cases, continuous epidural administeration of clonidine (200ug/day) and 0.3% bupivacaine(12 ml/day) produce high quality pain relief. These results suggest that antinociceptive effect of epidural clonidine is assumed to result from activation of ${\alpha}_2$-adrenergic receptors in the dorsal horn of the spinal cord.

• Journal of Yeungnam Medical Science
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• 제2권1호
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• pp.265-269
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• 1985

십이장에 있는 Brunner씨 선의 양성증식성 병변은 상당히 희유한 변화이다. 지금까지 영문으로 보고된 증례는 대체로 120예를 넘지 않는다. 1835년 Cruveilhier에 의해 처음 증례가 보고되었는 바 대부분의 증례는 양성종양 또는 양성증식성병변으로 나타나나 이 때까지 2예의 악성종양도 보고 되었다. 방사선진단법의 개선과 fibropic endoscopy의 이용으로 십이장의 종양성 병변의 조기진단과 치료에 많은 진전을 보았으며, 따라서 저자는 비교적 희유한 십이장에 생긴 Brunner씨 선에서 발생한 양성종양을 경험하였기에 이 때까지 보고된 문헌을 고찰하고 그 원인, 임상상적 소견, 진단 및 치료에 대한 경험예를 보고하는 바이다. 환자는 51세된 남자로서, 1983년 12월 9일 상북부 동통과 4 주간의 설사를 주소로 하여 본 병원 내과에 입원하여 1984년 l월 23일 ERCP에 의해 십이장에 polyp가 있는 것을 확인하고 외과에서 적출하여 명리조직학적으로 Brunner씨 선에서 발생한 양성선종으로 진단하였다. 본 환자는 그 후 경과가 양호하여 수술후 1년 반까지 아무런 증상 없이 잘 지내고 있음이 확인되었다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권3호
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• pp.200-205
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• 2013

We present a case of a 47-month-old female suffering from acute urinary bladder neck obstruction and bilateral hydronephrosis secondary to a fecaloma. Fecaloma is defined as an accumulation of inspissated feces in the colon or rectum giving the appearance of an abdominal mass. A fecaloma can be developed by diverse causes and the causes of the fecaloma in this case were septum reformation after the Duhamel procedure and long-term constipation. Chronic constipation is very common at outpatient clinic. However, acute urinary retention and voiding difficulty caused by fecaloma in the giant Duhamel pouch has never been reported in Korea. We would like to present our case with acute urinary retention due to a fecaloma and suggest that fecaloma might be considered as one of the causes for acute urinary retention, especially in cases with previous Duhamel operation for repair of Hischsprung disease.

• 한국임상수의학회지
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• 제33권1호
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• pp.43-47
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• 2016

A 7-year-old castrated male Schnauzer was presented with melena and inappetence. Laboratory examination revealed mild anemia. Abdominal ultrasonography showed abnormal enlargement of intestinal segment and a oval mass with soft tissue density. After surgical resection of the enlarged intestine including the mass, histopathologic examination showed that the mass was tentatively diagnosed as synchronous occurrence of gland cell- and mesenchymal cell-origin tumors. Subsequently, immunohistochemistry showed positivity to cytokeratin AE1/AE3 in the gland cells and positivity to ${\alpha}-smooth$ muscle-specific actin, but negative expression of c-Kit, suggesting the co-existence of adenocarcinoma and leiomyosarcoma. Follow-up examination after 3-year of the surgery confirmed that the dog remained healthy and did not show recurrence of the tumors.

• The Korean Journal of Pain
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• 제1권1호
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• pp.125-128
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• 1988

A case of the left stellate ganglion block (SGB) with a warm serration of the left lower extremity in a 25-year-old male soldier is presented. During the Korean War, this patient received a penetrating gun shot wound from the right knee through the left abdominal wall, left upper arm and left thumb. He was evacuated to the a marine corps surgical hospital where amputation of the left thumb and an end-to-end anatomosis of the left brachial artery were performed. After surgery, left ulnar and median nerve paralysis and causalgia developed and about 9 months later an upper thoracic ganglionectomy was proposed at the Chin-Hae Navel Hospital. Before the ganglionectomy a stellate ganglion block for diagnostic and prognostic purposes was requested by the surgeon. This block was performed by the supraclavicular anterior approach using 10 ml of 2% procaine. The effect of the block including Horner's syndrome was confirmed 5 minute later in this patient. This patient returned to the ward by walking unassisted 10 minutes after the block, and complained of a warm sensation in the left lower extremity 20 minutes later as well as the left upper arm. This warm sensation in the lower extremity following ipsilateral stellate ganglion block indicates that the local anesthetics solution injected tinto the neck spread down to lumbar sympathetic ganalgion along the fascial membrane of the sympathetic chain as a consequence of the 10 minutes walk.

• 한국임상수의학회지
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• 제17권2호
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• pp.381-387
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• 2000

Efficacy of a 1% solution of sodium carboxymethylcellulose (SCMC) infu7ed into the peritoneal cavity of dogs was evaluated for prevention of intraperitoneal adhesion, resulting from operations of the reproductive tract. Saline-treated deles (n = 5) were controls that underwent ventral midline celiotomy, and adhesions were cleated by incision and scraping about 5 cm segment of each uterine horn. Saline (7 ml/kg of body weight) was then infused into the peritoneal cavity. Others (n = 5) were treaded similarly to the saline-treated dogs. except that 1% SCMC :solution (7mH/kg of body weight) was infused into the peritoneal cavity. This group was studied to determine whether SCHC would prevent the adhesions in the peritoneal cavity, especially in the uterine horn model. Abdominal adhesions were evaluated and an adhesion severity score was assigned to each dog on the basis of severity of adhesions. At the time of necropsy. the mean adhesion score in the saline treated group was $2.65{\pm}0.22.$ In contrast, adhesion formation in the SCMC treated group was less ($mean score =1.70{\pm}0.26$). Statistic71 analysis was performed using the grouped t-test and paired t-test. A significanlty lower adhesion score was observed in dogs given SCMC than in the saline treated group (P<0.01). In summary, SCMC significantly reduced adhesion formation in the dog uterine horn model. The results of this study suggest that application of 1% SCMC solution, following various reproductive pelvic surgery, will present the adhesions.

• Journal of Genetic Medicine
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• 제15권1호
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• pp.38-42
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• 2018

WAGR (Wilms tumor, aniridia, genitourinary anomalies, and mental retardation) syndrome is a rare contiguous gene deletion syndrome caused by deleting genes including WT1 and PAX6 genes in 11p13 region, which is characterized by Wilms tumor, aniridia, genitourinary abnormalities, and intellectual disability. We report the clinical and cytogenetic characteristics of one Korean patient with WAGR syndrome. The patient shows bilateral sporadic aniridia and genital anomalies at 2 months of age. A heterozygous 14.5 Mb interstitial deletion of 11p14.3p12 region was detected by array comparative genomic hybridization. At 2 years and 10 months of age, Wilms tumor is found through regularly abdominal ultrasonography and treated by chemotherapy, radiation therapy and surgery.

• 대한임상독성학회지
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• 제2권1호
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• pp.58-62
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• 2004

Acid ingestion can cause not only caustic injury on esophagus and stomach but also fatal outcome through systemic complications. We report the case of a patient who died early after severe caustic injury with strong acid. A 38-year-old man who ingested about 400ml of hydrochloric acid of unknown concentration was transferred to our hospital from a private clinic, in which he was managed with gastric irrigation through a nasogastric tube. He was complaining dyspnea and abdominal pain. Physical examination demonstrated tenderness and rebound tenderness on epigastric region. Severe metabolic acidosis and leukocytosis were noted. Radiological findings suggested perforation of gastrointestinal tract, although the physical signs were not typical. Endoscopy revealed caustic injuries of grade I on esophagus and of grade Ⅲ on stomach, which indicate more severe injury on the stomach than on the esophagus. Exploratory surgery was recommended but unfortunately not permitted by his family. Despite intensive measures, his vital signs deteriorated rapidly and he died 50 hours after the ingestion.