• Tuberculosis and Respiratory Diseases
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• 제45권4호
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• pp.870-875
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• 1998

방선균과 아스페르질루스종 각각은 비교적 흔한 질환이나 폐의 동일 병변에서 방선균과 아스페르질루스가 혼합 감염된 예는 보고 된 바가 없는데 최근 객혈로 내원한 62세 여자 환자의 고립성 폐결절에서 방선균파 아스페르질루스의 혼합 감염을 확인하였기에 보고 하는 바이다.

• Investigative Magnetic Resonance Imaging
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• 제17권3호
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• pp.243-248
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• 2013

원발성 후복막 점액낭샘암종은 매우 드문 질환으로 현재까지 전 세계적으로 51예가 보고 되었고 이 중 임산부에서 발생한 사례가 3예 있었다. 저자들은 31세 여성에서 임신 15주 3일에 발견된 원발성 후복막 점액낭샘암종의 자기공명영상 소견을 보고하고자 한다. 복부 자기공명영상에서 후복막강 내에 위치한 종괴는 경계가 좋은 낭종으로 불규칙하게 두꺼워진 낭벽과 내부에 중벽을 가지고 있으며, T1강조영상과 T2강조영상에서 다양한 신호강도를 보이는 부위를 포함하고 있었다. 수술을 통해 원발성 후복막 점액낭샘암종으로 진단 받았고 수술 15개월 후 양측 난소에 전이성 점액낭샘암종이 발생하여 전자궁적출술과 양측 난소난관절제술 및 대망절제술을 시행하였다.

• Clinical and Experimental Reproductive Medicine
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• 제38권2호
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• pp.109-114
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• 2011

Peritoneal pregnancy is an implantation in the peritoneal cavity exclusive of tubal, ovarian, or intra-ligamentary implantations. This is a rare obstetric complication with high maternal mortality and even higher perinatal mortality, and secondary type was most common. Risk factors for peritoneal pregnancy are previous history of extrauterine pregnancy or tubal surgery pelvic post-inflammatory status or presence of an intrauterine device. As it is a life-threatening condition, expectant management carries a risk of sudden life-threatening intra-abdominal bleeding and a generally poor fetal prognosis. So, when it is recognized, immediate termination of pregnancy is usually recommended. Early diagnosis of peritoneal pregnancy is difficult, but is important by their life threatening progress course to patients. Recently, we experienced primary peritoneal pregnancy which meets both the original and modified criteria. In this paper, we reported the case of early diagnosed and successfully treated peritoneal pregnancy despite of their diagnosis was incidentally.

• Tuberculosis and Respiratory Diseases
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• 제69권6호
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• pp.480-482
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• 2010

Rectus sheath hematoma (RSH) is a rare condition caused by hemorrhage into the rectus sheath. It is usually associated with severe cough, abdominal surgery, coagulopathy, and anticoagulation treatment. RSH can be difficult to diagnose and can be misdiagnosed as acute appendicitis, as diverticulitis, or as an ovarian mass. Although RSH usually presents as a benign condition, it can be life threatening, especially in the critically-ill patient. Here, we report a case of fatal RSH due to hypovolemic shock in a critically-ill 73-year-old woman, who had received heparin treatment due to acute myocardial infarction in the intensive care unit and who had been successfully treated by conservative management.

• The Korean Journal of Pain
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• 제6권1호
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• pp.55-59
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• 1993

Using a visual analogue scale, we compare the effect of patient-controlled analgesia and conventional intramuscular opioid regimen in 68 patients undergoing lower abdominal or gynecological surgery. We also recorded the incidence of side effects. We checked visual analogue scale 4 hours interval for 30 cases managed by patient-controlled analgesia and 38 cases of conventional intramuscular opioid group managed by obstetrician. We maintained fentanyl $0.33{\mu}g/kg/hr$ and set self administrable bolus dose $5.0{\mu}g$(lockout interval: 15 min) in patient-controlled analgesia group. Conventional intramuscular bolus injection group were administered meperidine 50 mg for 4 hour interval. Mean visual analogue scale scores obtained by patient-controlled analgesia group and intramuscular bolus injection group were $2.49{\pm}0.67$ and $4.53{\pm}1.28$(p<0.05). Side effects such as; no significant incidence of respiratory depression, urinary retention, postural hypotension, nausea, vomiting and pruritus were developed by either group. These results suggest that patient-controlled analgesia was more effective method compared with conventional intraumuscular opioid injection regimen for post-operative pain management.

• 한국임상수의학회지
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• 제25권6호
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• pp.494-500
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• 2008

The aim of this study was to determine the effectiveness of hyaluronic acid-carboxymethylcellulose membrane (GUARDIX-$MB^{(R)}$) barriers on prevention against post-operative peritoneal adhesions. In this study, fourteen mongrel dogs were divided into two experimental groups: 0.1 % hyaluronic acid (0.1HA) group and hyaluronic acidcarboxymethylcellulose membrane (HA-CMC) group. In order to induce adhesions, the anti-mesenteric serosa of the ileum was exteriorized and then abraded in a standard manner by scraping with a scalpel blade to create homogenous petechial hemorrhagic surface over a $1\;{\times}\;1cm$ area. Solution of 0.1HA were simply coated over the abraded tissues, $1.5\;{\times}\;1.5cm$ HA-CMC membrane was placed over the abraded tissues, allowed to spread across the intra-abdominal organs before closure of the abdomen. On day 1 before and day 1, 4, 7, 14, and 21 after operation, venous blood specimens were collected for measurement of fibrinogen and total WBC. The adhesions were blindly assessed 3 weeks later by using a computerized tensiometer. The fibrinogen and total WBC values of two groups showed no statistical significances. The mean tensile strength (gram force, gf) of formed adhesions day 21 after surgery was $88.1\;{\pm}\;55.70gf$ in the 0.1 % HA group and $24.8\;{\pm}\;22.69gf$ in the HA-CMC group. The tensile strength values of adhesion separation HA-CMC membrane group was significantly lower than the 0.1HA group (p<0.05). Therefore, we suggest that HACMC membrane reduce peritoneal adhesions may be applicable to preventing post-operative intraperitoneal adhesions in dogs.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제2권2호
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• pp.211-216
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• 1999

식도열공 탈장은 그 형태에 따라 진단 및 치료가 지연될 경우 반복되는 구토, 빈혈, 영양실조, 출혈, 감돈, 위궤양, 급성 위팽만 등의 합병증이 발생하여 치명적일 수 있다. 저자들은 심한 탈수와 영양 실조를 주소로 내원한 10개월 남아에서 단순 흉부촬영에서 우측 흉부 종괴로 오인되었으나 선천성 식도열공 탈장과 위의 회전에 의해 상부 위장관 바륨조영술에서 우측 흉강내에 위가 위치한 것처럼 보였던 경우로 탈장 정복술과 위식도 역류방지술을 시행한 후 상기 증상이 호전된 제 3형의 선천성 식도열공 탈장 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Nutrition and Health
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• 제25권3호
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• pp.248-255
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• 1992

This study was performed to investigate the effects of dietary protein content on recovery of laparotomized rats in terms of urinary epinephrine and norepinephrine plasma epinephrine and norepinephrine, . Fortyeigh male Sprague Dawley rats average-weighing 160g were divided into two diet groups ; LPD(10% low protein diet) group HPD(25% high protein diet) group After 3 days of adaptation period rats were given experimental diet for 14 days. Experimental period consists of 7-days pre-trauma and 7-days post-trauma period. Rats were laparotomized by 4cm abdominal incision under sodium pentobarbital anesthesia. During 7-days before and after the surgery urine and plasma were collected for the analysis of epinephrine and norepine-phrine. The results are as follows: 1) After laparotomy urinary epinephrine level was not increased in two diet groups. Urinary epinephrine concentration of rats in LPD group was considerably increased in post-trauma day 3 and thereafter gradually reduced. By post-trauma day 4 however urinary epinephrine concentration of rats in HPD groups was recovered to pre-trauma level 2) Urinary norepinephrine concentration of rats in LPD group was significantly increased after trauma(p<0.01) and the difference between LPD and HPD in post-trauma average norepinephrine concentration was not significant. 3) Post-traum average plasma epinephrine concentration was higher but not significant than that of pre-truma average in both groups [LPD(19.88ng/ml vs 20.93ng/ml) HPD(17.20ng/ml vs 19.37ng/ml)] 4) Plasma norepinephrine concentration of rats in LPD group was significantly increased in post-trauma period(p<0.01) In HPD group however post-trauma average plasma norepi-nephrine concentration was significantly lower than pre-trauma average. Thus the results suggest that norepinehrine concentration was affected by trauma and rats in HPD group excreted less amount of norepinephrine than rats in LPD group.

• Neonatal Medicine
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• 제28권1호
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• pp.29-35
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• 2021

Purpose: Intussusception is the most common cause of bowel obstruction in children; however, it is rarely diagnosed in newborn infants. This study aimed to describe the clinical features of intussusception in newborn infants. Methods: Medical records of eight patients diagnosed with intussusception during the newborn period at Ulsan University Hospital between March 2007 and March 2020 were retrospectively reviewed. Results: Among the eight cases, two occurred in the intrauterine period and six occurred in the postnatal period. Intrauterine intussusception presented with symptoms of bowel obstruction within 1 to 2 days after birth, and ileal atresia was diagnosed simultaneously through exploratory laparotomy. All the postnatal patients were extremely low birth weight infants (median gestational age and birth weight: 25⁺⁶ weeks and 745 g, respectively). Four cases were diagnosed preoperatively using abdominal ultrasonography. One patient was diagnosed by exploratory laparotomy because the clinical symptoms were nonspecific and difficult to differentiate from those of necrotizing enterocolitis, a more prevalent complication in preterm infants. The site of intussusception in all six patients was the small bowel. Meckel's diverticulum (one case) and meconium obstruction (two cases) were found to be the lead point. Conclusion: Neonatal intussusception tends to show different clinical features according to its period of occurrence. Intussusception, especially in preterm infants, has nonspecific clinical features; therefore, clinicians should always be cautious of this disease for its early diagnosis.

• Perinatology
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• 제29권4호
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• pp.189-194
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• 2018

Congenital neuroblastoma is a rare disease. Placental metastasis is extremely rare and poor prognosis has been reported in neonates. Mirror syndrome could occur in mother with placental metastasis with possibilities of hypertension and edema. We report a case of detection of left suprarenal mass in fetus at $31^{+5}weeks^{\prime}$ gestation. Mother presented with palpitation, edema, headache, and hypertension. Maternal 24 hours urine vanillylmandelic acid (VMA) and normetanephrine (NME) level at 34 weeks' gestation were elevated. Consequently, emergent cesarean section was done. Based on abdominal ultrasonography and whole body magnetic resonance imaging, left adrenal tumor with liver metastasis was suspected. Neuroblastoma was confirmed by liver and placenta biopsy. Chemotherapy was started with Pediatric Oncology Group 9243 at day 7 and changed into Children's Oncology Group 3961 due to cholestasis and poor response during 2nd cycle. Plasma exchange was done for aggravated direct hyperbilirubinemia. The baby expired at 73 days due to multi-organ failure. Maternal symptoms were completely resolved in 2 weeks after delivery along with normalization of the elevated level of VMA and NME. We report a first case of mirror syndrome in Korean mother and fetus resulting from metastatic congenital neuroblastoma to placenta.