• Title/Summary/Keyword: Abdominal wall

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Gastric wall abscess after endoscopic submucosal dissection

  • Seung Jung Yu;Sang Heon Lee;Jun Sik Yoon;Hong Sub Lee;Sam Ryong Jee
    • Clinical Endoscopy
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    • v.56 no.1
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    • pp.114-118
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    • 2023
  • Gastric wall abscess, a localized form of phlegmonous gastritis, is a rare complication of endoscopic resection. We report the first case of gastric wall abscess developing after endoscopic submucosal dissection in Korea. A 72-year-old woman visited our clinic to receive treatment for gastric adenoma. The patient successfully underwent endoscopic submucosal dissection with no complications. The final diagnosis was well-differentiated tubular adenocarcinoma. We performed follow-up endoscopy 10 weeks later and found a large subepithelial lesion on the posterior wall of the gastric antrum. Abdominal computed tomography revealed hypodense wall thickening and a 5 cm heterogenous multilobular mass in the submucosal layer of the gastric antrum. Submucosal invasion with mucin-producing adenocarcinomas could therefore not be excluded. The patient agreed to undergo additional gastrectomy due to the possibility of a highly malignant lesion. The final diagnosis was acute suppurative inflammation with the formation of multiple abscesses in the mural layers and omentum. The patient was discharged with no complications.

Utility of a modified components separation for abdominal wall reconstruction in the liver and kidney transplant population

  • Black, Cara K;Zolper, Elizabeth G;Walters, Elliot T;Wang, Jessica;Martinez, Jesus;Tran, Andrew;Naz, Iram;Kotha, Vikas;Kim, Paul J;Sher, Sarah R;Evans, Karen K
    • Archives of Plastic Surgery
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    • v.46 no.5
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    • pp.462-469
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    • 2019
  • Background Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. Methods This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. Results The mean age of patients was $61.0{\pm}8.3years\;old$, with a mean body mass index of $28.4{\pm}4.8kg/m^2$, 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of $28.7{\pm}22.8months$. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. Conclusions This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.

The Effects of Aging and Atherosclerosis on Elastin of Human Aortas; Quantitative Analysis of Elastin-Content and SEM Analysis of Elastolysis

  • Song, Seh-Hoon;Roach, Margot R.
    • The Korean Journal of Physiology and Pharmacology
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    • v.2 no.5
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    • pp.591-600
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    • 1998
  • We have examined 24 human aortas aged $46{\sim}90$ years obtained from autopsies. Most exhibited gross lesions of some degree on the lumenal surface. Using hot alkaline treatment (0.1 N NaOH) at $70{\sim}75^{\circ}C$ for 5 hours, we extracted and quantitated elastin portions from the aortic wall in 3 different segments (UTA=upper thoracic aorta, LTA=lower thoracic aorta, AA=abdominal aorta). We have found UTA had $70.6%{\pm}1.39$ (SE), LTA $61.6%{\pm}1.94$ (SE), AA $49.2%{\pm}1.84$ (SE) elastin respectively based on wet weight. The differences between segments are statistically significant (p<0.05, 0.025). However, there is no significant correlation between the age of the patients and the relative amounts of elastin in each segment. We have also observed the structure of elastin in the internal elastic lamina (IEL) and tunica media (TM) with SEM (scanning electron microscopy), and discovered that the IEL shows various forms of elastolysis- broken sheets, discontinuity, various sizes of lumps, vesicles, and possible newly formed elastin in the aortic lesions (Song and Roach submitted to YMJ). From these studies we conclude that elastin in the aortic wall remains well balanced quantitatively with age in spite of evidence suggesting vigorous degeneration and regeneration in the atherosclerotic lesions.

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Chronic Suppurative Steatitis Secondary to Pancreatitis in a Dog (개의 췌장염에 의한 만성 화농성 지방조직염증)

  • Choi, Ji-Hye;Kim, Hyun-Wook;Jang, Jae-Young;Seo, Ji-Min;Lee, Min-Jung;Choi, Ul-Soo;Kim, Mi-Eun;Yoon, Jung-Hee
    • Journal of Veterinary Clinics
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    • v.26 no.1
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    • pp.76-80
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    • 2009
  • A Maltese was presented with a subcutaneous mass at right flank, depression and hyperthermia. Ultrasonography revealed a hypoechoic mass with hyperechoic foci, a defect of abdominal wall and peritonitis. In cytology, fat necrosis was found. This dog was diagnosed as chronic suppurative steatitis secondary to pancreatitis and pancreatic herniation through surgery and histopathologic examination. Steatitis is recurrent inflammation and necrosis of adipose tissue. Also steatitis associated with pancreatic diseases such as pancreatitis and pancreatic tumor was reported and direct fat necrosis by pancreatic enzyme was supposed as the etiology. Steatitis secondary to pancreatitis was rarely reported in dogs and there was difficulty in diagnosis and treatment. This case has a limitation that pancreatitis was not diagnosed as underlying cause to steatitis before surgery. However, a defect of abdominal wall and peritonitis were observed on ultrasonography. Good prognosis could be achieved through prompt surgery and medical treatment.

Subcutaneous Cysticercosis at Abdominal Wall: Case Report (복벽에 발생한 낭미충증 1례)

  • Kim, Eui Sik;Park, Jeong Jun;Noh, Bok Kyun;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • v.33 no.2
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    • pp.249-251
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    • 2006
  • Human cysticercosis is an infestation with C. cellulosae, the larval stage of the tapeworm T. solium. It prevails in regions of poverty and where personal hygiene is poor. They can lodge in almost any tissue, but cysticerci are most frequently found in brain, skeletal muscle, subcutaneous tissues. We experienced a 41-year old male with $5{\times}12cm$ sized movable non tender brownish hard mass at lateral abdominal wall. The laboratory study didn't show any specific symptoms except peripheral blood eosinophilia and positive parasite ELISA screen for cysticercosis. The ultrasonogram revealed multiple ill-defined mixed echoic inflamatory lesion. Excisied cyst showed multiple severe foul-odor gelatinous subcutaneous mass. Microscopic examination disclosed necrotic body with foreign body reaction, massive eosinophilia and dead parasitic organism, compatible with cysticercosis. There was no evidence of recurrence during 12 months follow-up.

A Study on the Measurement of Wall Shear Rate in the Abdominal Aortic Aneurysm (복부대동맥류 벽 전단변형률 측정에 관한 연구)

  • 오성은;이계한
    • Journal of Biomedical Engineering Research
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    • v.21 no.2
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    • pp.181-187
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    • 2000
  • 동맥의 일부분이 팽창하는 동맥류는 파열로 인한 높은 사망률을 야기한다. 동맥류의 발생 및 파열에는 혈관벽의 구조적 약화와 혈류에 의한 응력이 중요한 역할을 하며, 혈류에 의해 혈관벽에 가해지는 전단응력은 간접적으로 혈관벽 구조를 변화시키고, 직접적으로 혈관벽에 응력을 가하므로 동맥류 파열에 영향을 미치는 중요한 혈류역학적 인자이다. 동맥류가 자주 발생하는 복부대동맥류 모델을 제작하여 정상류와 맥동류 유동에서 광색성 염료를 이용한 유동가시화 방법으로 벽 전단변형률을 측정하였다. 벽전단변형률은 동맥류 내부에서 감소하여 음의 값을 가지며, 동맥류 최대확장부 후부에서 다시 증가하여 확장부가 끝나는 위치에서 동맥 벽에 비해 약 1.5배 정도의 큰 전단변형률 값을 가졌다. 동맥류 최대확장부 후부에서는 벽전단변형률의 방향의 바뀌며, 위치에 따른 전단변형률의 변화가 크게 나타났다. 맥동류 유동에서는 동맥류의 위치에 따라 시간에 따른 벽전단형률 파형이 측정되었다. 동맥류 내부에서는 전단변형률의 크기가 작고 그 방향이 시간에 따라 변화가 심하였으므로 혈관벽의 구조변화가 발생하기 쉬운 지역으로 지목된다. 동맥류 최대 확장부 후부는 위치 및 시간에 따른 전단변형률의 변화가 심하며, 혈관벽 응력이 최대값을 갖는 지역이므로 동맥류의 파열이 발생하기 쉬운 지역으로 예측된다.

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CT Findings of Desmoid Tumor arising at Abdominal Wall: Two Cases Report (복벽에 발생한 데스모이드 종양의 급속 조영 CT 소견 : 2례 보고)

  • Cho, Dae-Hyoun;Cho, Jae-Ho;Chang, Jae-Chun
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.386-392
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    • 1995
  • Desmoid tumor is a type of fibromatosis usually arise in deep musculo-aponeurotic structures, primarily of the trunk and extremities. It is characterized by proliferation of fibroblastic tissue and does not metastasize but may be locally aggressive. Eventhough the surgical margin reveals clean, recurrence often occurs. To analyze the extent of the tumor and homodynamic characteristics exactly, we performed IV bolus CT. Desmoid tumors show peripheral rim enhancement on early phase scan and more strong, central enhancement on late phase IV bolus CT, which reflects abundant fibroblastic components of the tumor. We report two cases of pathologically confirmed desmoid tumor performed IV bolus CT.

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The Method of Inserting Operation of T-type Cannula into the Proximal Duodenum of Cattle (소의 십이지장 캐뉼라 시술법)

  • Nho, Whan-Gook;Lee, Jang-Hyung
    • Journal of Practical Agriculture & Fisheries Research
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    • v.6 no.1
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    • pp.136-142
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    • 2004
  • The method of insertion of T-type cannula into the proximal duodenum of cattle was established for the feed digestibility test. Five cattle were anesthetized with rumpun and 2% lidocaine. The incision(15 ~ 20 cm) through the abdominal wall exposing the peritoneal cavity was made. The identified duodenum was extracted through the abdominal incision. The cannula was inserted into the incised duodenal wall. Cannula barrel was extracted between the 10th and 11th rib. All of operated cattle were healthy and cannula remained completely functional until 20 months after a proximal duodenal cannulation.

Responses of Autonomic Nervous System and Gastrointestinal Function to Acupuncture at Abdominal Anterior Cutaneous Nerve : A Pilot Study (복부전방피부신경 영역의 자침으로 유발한 자율신경 및 위장관기능 변화에 대한 연구)

  • Park, Seohyun;Kim, Hojun;Keum, Dongho
    • The Journal of Korean Medicine
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    • v.40 no.1
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    • pp.99-113
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    • 2019
  • Objectives: This study is designed to identify the responses of autonomic nervous system and gastrointestinal function which are induced by acupuncture at abdominal anterior cutaneous nerve. Methods: This study is one group before and after pilot study. Subjects were treated once, after having been fasting six hours. They had before tests, labeling points for acupuncture, acupuncture, and after tests in order. The points of acupuncture were motor points of rectus abdominis where the abdominal anterior cutaneous nerve came to the skin from abdominal wall. Before and after tests were consisted of three things: Digital Infrared Thermographic Imaging(D.I.T.I.), Heart Rate Variability(HRV), and Recording of bowel sounds. Results: There were significant differences on the skin temperature of upper body and the frequency of bowel sounds(p<0.001, p<0.001). The HRV parameters and volume of bowel sounds had no significant differences(p>0.05, p>0.05). Conclusion: Even though no significant differences in HRV parameters, the significant differences of skin temperature of upper body and frequency of bowel sounds could mean acupuncture at abdominal anterior cutaneous nerve could affect the autonomic nervous system and gastrointestinal function. However, this study had no group to compare with. Future randomized project should address this issue.

Long-term Survival after Repeated Local Therapy and Salvage Chemotherapy for Recurrent Metastases from Gastric Cancer: a Case Report and Literature Review

  • Kwon, Jihyun;Han, Hye Sook;Kim, Hee Kyung;Baek, Seung-Woo;Yang, Yaewon;Lee, Ki Hyeong;Son, Seung-Myoung;Kim, Won-Dong;Kim, Dae Hoon;Yun, Hyo Yung
    • Journal of Gastric Cancer
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    • v.18 no.3
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    • pp.305-312
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    • 2018
  • We report a rare case of long-term survival in a patient who received local therapy and salvage chemotherapy for recurrent metastases, along with a literature review. A 65-year-old male patient underwent subtotal gastrectomy for advanced gastric adenocarcinoma. Six months after gastrectomy, 2 metastatic intra-abdominal lymph node enlargements were detected, which were treated with radiotherapy. At 55 months after gastrectomy, an abdominal wall mass was detected, which was treated by surgical resection. The patient received 5-fluorouracil/leucovorin/irinotecan chemotherapy for 27 months before and after radiotherapy and docetaxel chemotherapy for 6 months after surgical resection of the abdominal wall metastasis. At the last visit, 7.8 years since the initial resection of the primary gastric cancer and 6.2 years since detection of the first metastases, the patient was disease-free and required no further chemotherapy. This case suggests that repeated local therapy offers potential for long-term survival in a carefully selected subset of patients with recurrent metastases.