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A Case of Successful Endoscopic and Conservative Treatment for Intentional Ingestion of Sharp Foreign Bodies in the Alimentary Tract (고의로 섭취한 커터칼날의 내시경 및 보존적 치료 증례 보고)

  • Park, Jong-Min;Kim, Seong Yup;Chung, Il Yong;Kim, Woo-Shik;Shin, Yong-Chul;Kim, Yeong Cheol;Park, Sei Hyeog
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.304-307
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    • 2013
  • Food bolus impaction is the most common cause of esophageal foreign body obstruction in adults. Other causes include intentional ingestion in psychiatric patients or prison inmates. We experienced successful treatment of a patient with intentional ingestion of multiple sharp foreign bodies(25 cutter and razor fragments). A 47-year-old male patient who was suffering from chronic alcoholism was admitted, via the emergency room, with dysphagia and neck pain. He was suffering from alcoholic liver cirrhosis and psychiatric problems, such as chronic alcoholism, anxiety disorder and insomnia. The patient had intended to leave the hospital after having swallowed the sharp objects. Plain radiographs and computed tomography (CT) scan showed multiple, scattered metal fragments in the esophagus, stomach, and small bowel. We performed emergent endoscopy and successfully removed one impacted blade in the upper esophagus using by a snare with an overtube. The rest of the fragments had already passed through the pylorus, so we could not find them with endoscopy. We checked the patient with simple abdominal radiographs and careful physical examinations every day. All remaining fragments were uneventfully excreted through stool during the patient's 6 day hospital stay. Finally, we were able to confirm the presence of the objects in the stool, and radiographs were negative. The patient was discharged without complications after 14 days hospital stay and then was followed by the Department of Psychiatry.

SVC Syndrome Caused by Leiomyosarcoma of SVC - A Case Report - (상대정맥에 발생한 평활근육종의 수술 - 1례 보고 -)

  • 손영상;류세민;손호성;조원민;황재준;최영호;김학제;심재정;조성준
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.235-238
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    • 2002
  • Among the causes of SVC syndrome, intraluminal tumor, especially the leiomyosarcoma is very rare. We report a 39 year old female patient who had been suffering from headache and facial edema for 6 weeks before admission. On physical examination, facial edema and venous engorgement on upper extermities and upper chast wall were showed. The chest CT scan and SVC cavogram showed a long intraluminal mass lesion resulting in a near total obstruction of the SVC Surgery was performed through median sternotomy. For complete resection of the tumor and thrombus, we used partial and total CPB. The follow up SVC cavogram revealed no abnormality 14 months after the operation.

Internal Radiotherapy of Metastatic Hepatic Malignancy Using Colloidal P-32 in Various Gabtrointebtinal Tumors - The First Report: Prevention of Liver Metastasis Using Colloidal p-32 in Colo-Rectal Cancer- (각종(各種) 소화기암(消化器癌)에서 교질성(膠質性) 방사성(放射性) 인(燐)을 이용(利用)한 전이성(轉移性) 간암(肝癌의) 방사선(放射線) 내부치료(內部治療) -제1보(第1報) : 대장(大腸)-직장암(直腸癌)에서 교질성(膠質性) 인(燐)을 이용(利用)한 간전이(肝轉移)의 예방(豫防)-)

  • Kim, Ji-Yeul;Bom, Hee-Seung;Choi, Won;Kim, Young-Jin
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.2
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    • pp.274-278
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    • 1990
  • Metastases to the liver presents a common clinical problem in the management of patients with cole-rectal cancer, and are responsible for a high degree of morbidity and mortality associated with this malignancy. Unfortunately, attempts at preventing the development of liver metastases in "high risk" patients has so far been unsuccessful. Ongoing studies of adjuvant chemotherapy have not yet illustrated a significant increase in survival in patients receiving such therapy. The purpose of the study is to investigate the value of adjuvant radiotherapy given in the form of colloidal chromic phosphate P-32 suspension administered via portal vein after radical resection of the primary cancer, in preventing the growth of occult metastases in the liver. Twenty one patients (10 patients of treated group with 11 controls) were followed 18 months after operation. There was no significant change in the CBC and liver functions after administration of P-32 labeled colloidal chromic phosphate. The number of patients who showed local metastases at 18 months were 2 in the treated group and 3 in the control group. While liver metastases occurred in one patient at 6 months and in three at 12 months in the control group, there was no development of liver metastases by 12 months in the treated group. At 18 month follow-up CT scan one patient in the treated group showed a single nodule in the liver. In conclusion liver metastasis rate was lower in the patients who received colloidal P-32 chromic phosphate via portal vein after radical resection of the primary cole-rectal cancer.

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Descending Aorto-bronchial Fistula after Ascending Aorta Graft Interposition for Type I Acute Aortic Dissection (제1형 급성 대동맥 박리증의 상행 대동맥 치환술 후 하행 대동맥에 발생한 대동맥-기관지루)

  • Ryu, Kyoung-Min;Ryu, Jae-Wook;Park, Seong-Sik;Kim, Seok-Kon;Seo, Pil-Won
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.578-581
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    • 2007
  • A 59-year old female patient was admitted due to massive hemoptysis. 6-months previously, we performed ascending aorta graft interposition for terating Debakey type 1 acute aortic dissection. Chest CT scan showed the fistula between the descending thoracic aorta and the left lower lobe. We performed descending thoracic aorta graft interposition under cardiopulmonary bypass. She recovered well without any postoperative problems. Distal aorto-bronchial fistula after a previous aortic operation is very rare. We report here the good results of treating aorto-bronchial fistula because we recognized this lesion early and performed an early operation.

Understanding Phytosanitary Irradiation Treatment of Pineapple Using Monte Carlo Simulation

  • Kim, Jongsoon;Kwon, Soon-Hong;Chung, Sung-Won;Kwon, Soon-Goo;Park, Jong-Min;Choi, Won-Sik
    • Journal of Biosystems Engineering
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    • v.38 no.2
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    • pp.87-94
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    • 2013
  • Purpose: Pineapple is now the third most important tropical fruit in world production after banana and citrus. Phytosanitary irradiation is recognized as a promising alternative treatment to chemical fumigation. However, most of the phytosanitary irradiation studies have dealt with physiochemical properties and its efficacy. Accurate dose calculation is crucial for ensuring proper process control in phytosanitary irradiation. The objective of this study was to optimize phytosanitary irradiation treatment of pineapple in various radiation sources using Monte Carlo simulation. Methods: 3-D geometry and component densities of the pineapple, extracted from CT scan data, were entered into a radiation transport Monte Carlo code (MCNP5) to obtain simulated dose distribution. Radiation energy used for simulation were 2 MeV (low-energy) and 10 MeV (high-energy) for electron beams, 1.25 MeV for gamma-rays, and 5 MeV for X-rays. Results: For low-energy electron beam simulation, electrons penetrated up to 0.75 cm from the pineapple skin, which is good for controlling insect eggs laid just below the fruit surface. For high-energy electron beam simulation, electrons penetrated up to 4.5 cm and the irradiation area occupied 60.2% of the whole area at single-side irradiation and 90.6% at double-side irradiation. For a single-side only gamma- and X-ray source simulation, the entire pineapple was irradiated and dose uniformity ratios (Dmax/Dmin) were 2.23 and 2.19, respectively. Even though both sources had all greater penetrating capability, the X-ray treatment is safer and the gamma-ray treatment is more widely used due to their availability. Conclusions: These results are invaluable for optimizing phytosanitary irradiation treatment planning of pineapple.

Fine Needle Aspiration Cytology of Retroperitoneal Paraganglioma with an Unusual Pattern - A Case Report - (비전형적인 세침흡인 세포학적 소견을 보인 후복막강 부신경절종 - 1례 보고 -)

  • Kim, Jean-A;Kim, Young-Shin;Kang, Chang-Suk;Lee, An-Hi;Kim, Byung-Kee;Shim, Sang-In;Kim, Sun-Moo
    • The Korean Journal of Cytopathology
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    • v.5 no.1
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    • pp.74-78
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    • 1994
  • A case of retroperitoneal paraganglioma is presented with fine needle aspiration cytologic features. A 57-year-old woman complained of abdominal discomfort and left flank pain for 2 years. The abdominal CT scan revealed an ovoid mass left to the abdominal aorta. Percutaneous fine needle aspiration was performed from the mass. The smear revealed cellular sheets or groups on hemorrhagic background. The tumor cells were ovoid, round to spindle shaped with mild to moderate cellular pleomorphism. The nuclei were round to ovoid and had evenly dispersed chromatin and small nucleoli. The cytoplasm was amphophilic, finely granular and poorly defined. Cells having large or spindle nuclei were quite frequently observed, however, mitosis was not present The cytologic findings suggested paraganglioma, but the frequent spindle cell pattern and the pleomorphism made it difficult to exclude other endocrine tumors and sarcomas. The clinical, histological and ultrastructural findings as well as cytologic findings contributed to confirmatory diagnosis.

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Arterial Embolization for the Ruptured Splenic Artery Pseudoaneurysm in a Child (소아 가성비장동맥 파열의 동맥색전술 치험 1예)

  • Han, Seok-Joo;Lee, Do-Yun;Han, Ai-Ri;Choi, Gi-Hong;Oh, Jung-Tak;Choi, Seung-Hoon;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.6 no.2
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    • pp.143-148
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    • 2000
  • Pseudoaneurysm of the splenic artery may arise from a vascular erosion by a surrounding inflammatory processes in acute and chronic pancreatitis. Rupture of the pseudoaneurysm may threaten the patient's life. Conservative management for massive hemorrhage may cause 100 percent mortality and even with prompt therapy there is a high mortality. Preoperative detection of bleeding source is desirable because of the difficult identification of the bleeding site at laparotomy. Angiographic identification and embolization of the hemorrhagic vessels in selected cases may obviate the risk of urgent surgery. The authors have recently managed a case of ruptured splenic artery pseudoaneurysm combined with a pancreatic pseudocyst in a 6 years old boy. A bolus enhanced CT scan and angiography confirmed the diagnosis. We managed this child successfully with the urgent transcatheter arterial embolization followed by elective surgery.

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Abdominal Injury by Falls from a Height in Children (소아에서 추락사고에 의한 복부손상)

  • Choi, Kum-Ja
    • Advances in pediatric surgery
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    • v.11 no.2
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    • pp.115-122
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    • 2005
  • Falls from a height are the leading cause of injury and death among urban children. This study describes the incidence, clinical characteristics, and treatment results of children under 15 year of age who fell from a height of more than one meter and were admitted for abdominal injury. The medical records of 585 consecutive patients treated between January 1997 and December 2003 at Ewha Womans University Mokdong Hospital were analyzed retrospectively. The falling heights were 1 to 31.2 meters, and 28 patients(4.8 %) suffered from blunt abdominal trauma. The male to female ratio was 2.1: 1. The median age of the victims was 5.5 years, and the median height fallen was 3 meters. Fifteen patients (53.6 %) were injured during the summer and seventy-nine percent of the falls occurred between noon and 9 pm. Eighteen (64.3 %) of falls occurred in residential place and 19(67.8 %) of patients arrived at the emergency department within 30 minutes of the accident. Only 16 patients (57.1 %) complained of abdominal pain. Liver injuries were found in 12(42.9 %), spleen injuries in 5(17.9 %), kidney injuries 3(10.7 %), pancreatic injuries in 1(3.6 %) and nonspecific abdominal injuries in 9(32.1 %) cases. Increased SGOT and SGPT were found in 23(82.2 %) and 18(64.3 %) cases. Eleven patients (39.3 %) had associated head injuries. Limb injuries were present in 17.9% and thoracic injuries in 7.1%. Twenty-five patients (89.3 %) recovered without operation. The median length of hospital stay was 6 days (2 -20 days). Despite the absence of abdominal symptoms or shock, falls from a height in children may carry significant intra-abdominal organ injuries. The height falling could not predict the degree of the abdominal injury. For the evaluation of potential abdominal injuries, CT scan should be utilized.

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A Case of Bronchiolar Papilloma (세기관지 유두종 1예)

  • Lee, Sang Hak;Kim, Chi Hong;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak;Jang, Eun Deok
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.792-797
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    • 1996
  • A 59-year-old woman was admintted to the hospital because of intermittent fever and right side chest pain. She has a same episode eight months before this entry. Chest CT scan demonstrated ill-defined parenchymal consolidation containing dilated bronchi of right lower lung field, but no endobronchial mass in the bronchial trees. Fiberoptic bronchoscopy seeking the cause of recurrent pneumonia revealed a small, round mass nearly completely obstructing me lumen of basal segmental bronchus of right lower lobe. The diagnosis of bronchiolar papilloma was made from the biopsy specimens of the bronchoscopic examination. The patient was treated with right lower lobectomy because of irreversible secondary changes below the obstructed bronchus. This thoracotomic excision resulted in complete relief of symptoms and the postoperative course was uneventful for 12 months. Here we report a extremely rare umor with a brief review of literatures.

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A Case of Poncet's Disease in a Patient with Pulmonary Tuberculosis Accompanying Erythema Nodosum (결절홍반을 동반한 폐결핵환자에 나타난 Poncet병 1예)

  • Han, Na;Lee, Su-Kyeong;Kim, Tae-Jin;Song, Yun-Seok;Jung, Sun-Ho;Yang, Kyung-Ho;Choi, Sung-Jin;Shin, Won-Hyuk
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.3
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    • pp.221-224
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    • 2011
  • Poncet's disease is an aseptic polyarthritis developing in the presence of active Tuberculosis occurring elsewhere, and is not due to direct involvement of joints but to an immunological reaction to tuberculoprotein. We experienced a case of Poncet's disease accompanying erythema nodosum in a 55-year-old female patient with pulmonary tuberculosis. She had multiple tender erythematous nodules on both lower limbs for 3 months and a cough and sputum from one month ago. She felt severe pain in both knees and ankles with swelling one week before admission. Her chest X-ray, computed tomography (CT) scan and positive sputum AFB stain results revealed that she had active pulmonary tuberculosis accompanying erythema nodosum and aseptic polyarthritis. Her arthritis and erythema nodosum were dramatically improved within four weeks after anti-tuberculosis therapy. We report a case of Poncet's disease in pulmonary tuberculosis accompanying erythema nodosum.