• Advances in pediatric surgery
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• v.15 no.1
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• pp.52-57
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• 2009

Situs inversus abdominis is a rare congenital condition commonly associated with serious cardiac and splenic malformations. The importance of recognizing the presence of situs inversus abdominis preoperatively is emphasized by the fact that the surgical incision is placed on the incorrect side of the abdomen. A 6 day-old girl was referred to our hospital because of bile stained vomiting. A plain radiography of abdomen and chest showed the heart to be normal position and a reversed "double-bubble" picture with no other gas shadow in the rest of the abdomen. Abdominal computed tomography scan revealed situs inversus with the stomach and polysplenia on the right side and the liver on the left side. A laparotomy confirmed the diagnosis of situs inversus with duodenal atresia. The obstruction was bypassed by constructing a side-to-side duodenoduodenostomy. The postoperative course was uneventful.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.62-69
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• 2012

Purpose: The present study has an objective of effectively separating and making observations on a portion of radiopharmaceutical excreted via digestive organ to remain in the organ and invade a heart shadow. Materials and methods: When heart shadow is blocked by the organ in tests during a resting phase and a loaded phase, additional images were obtained using immobilization device. The immobilization devices were used to tilt the upper body forward from supine position. Results: In the reconstructed image for the separated case, as compared with the case where a part of organ is overlapped with heart, in terms of an overall mean value for each parameter, the end-diastolic volume increased by 2.75 mL, the end-systolic volume decreased by 3.16 mL, the left ventricle cardiac coefficient increased by 3.58%, and the area of defect region decreased by 3.58 and 3.92 cm for loading and resting phase, respectively. Conclusions: In the present study with myocardial perfusion SPECT, overlapped areas of heart and other organs could be effectively separated and visualization by the use of an immobilization device.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.929-935
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• 1990

Violence in our society, combined with improving transport system, resulted in increased numbers of patients with cardiac wounds reaching the hospital alive. Most patients with penetrating cardiac injury, rather than blunt injury, present with a syndrome of either hemorrhagic shock or cardiac tamponade. And they should be operated upon as soon as possible. Often the atrioventricular valves and other important cardiac structures are also damaged by the penetrating instruments or missile. Both intracardiac communications and atrioventricular fistulas may result in significant left-to-right shunts accompanied by congestive heart failure, necessitating surgical correction. Usually, retained cardiac foreign bodies, which are almost always bullets or fragments of missiles, may lie within a cardiac chamber or in the myocardium. Emboli of bullets or other missiles from distant sites to the right side of the heart are numerous enough to require attention. Recently we experienced a case with intracardiac foreign body due to penetrating cardiac injury. A 19 year-old man was admitted to our hospital due to penetrating anterior chest wound by iron segment. The roentgenogram of the chest revealed a radio-opaque metallic shadow in left lower chest around the cardiac apex, mild blunting of left costophrenic space, but no cardiomegaly. During operation the foreign body was noted to be present in the cardiac chamber by the portable C-arm fluoroscopy. But during the manipulation it moved into left inferior pulmonary vein from left ventricle by way of left atrium. So we could manage to remove it from left inferior pulmonary vein by direct approach to the vein. It was iron segment, sized 0.lcm x0.6cmx0.5cm, with sharp margins. The patient had an uneventful postoperative recovery except for chylopericardium and was discharged.

• Journal of Families and Better Life
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• v.32 no.2
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• pp.143-157
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• 2014

This study explored how a female college student from a wife-battering family overcame her negative father complex and found her femininity through sandplay therapy. The client wanted to have good relationships with people as a result of the therapy. Thirty-one therapy sessions were held. The initial phase of therapy included 1-7 sessions, the intermediate phase included 8-27 sessions, and the final phase included 28-31 sessions. The client expressed her empty heart, frozen femininity and potential to work that was blocked in terms of her internal work as well as in her ability to have relationships in the first phase of therapy. During the middle phase of therapy she pursued her real and authentic self by meeting her shadow and acknowledging the different viewpoints of others. In the final phase of therapy she welcomed a new world with determination of what she would do after graduation in a real life. Through sandplay therapy in a free and protected space, the client overcame her negative father complex and found her natural femininity.

• Sim-seong Yeon-gu
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• v.36 no.1
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• pp.55-86
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• 2021

The initial situation in our tale shows that the earth-mother-feminine principle disappeared from the center of the collective consciousness into the collective unconscious. Therefore the heaven-father-masculine principle is dominant, which is represented by the king. And in the king's daughter, who is living without mother, the positive father complex is working. She stays in the heaven-spirit world playing with the golden ball, which can be seen as the state of inflation. She is disconnected from the earth-mother-feminine principle, which is important for a woman to find her genuine feminine identity. This demanded principle approaches her through the frog, a bewitched prince. Psychologically it means that a man is under the power of the negative mother complex. The disgusting, ugly frog is a symbol for the shadow, the earthly animal instincts of the princess. Only with his help she can find her golden ball again, which has fallen into the deep well. Their talk about the rewards to him for his help shows us very well the opposites. The frog wants the feminine value such as relation, earthly eros, but the princess offers the masculine value such as heavenly logos. After the frog brought her the lost ball, i.e. she regained her libido, she completely forgot her promise. Like this the content, which is becoming conscious, here the shadow, is easy to fall back into the unconscious and to be repressed. The frog cannot be with the princess without the help of the king, a father figure, a firm protector of the collective oder. At first unwillingly the princess obeys Logos of her father. But her authentic instinctual urge grows stronger and it causes that her ego is released from the power of her father complex. At just this moment the frog turns into a prince, i.e. he is liberated from the mother complex. The marriage of princess and frog-prince symbolize the unification of the opposites: heaven becomes earthly and earth becomes heavenly. Three iron bands, wrapped around the heart of Heinrich, a young king's servant, are snapped, while he brings the prince and princess back to his kingdom. The heart, the place of earth-mother-feminine consciousness, is now liberated. This principle, which disappeared into the unconscious, emerged into the collective consciousness and the wholeness is recovered. The Self is now leading the collective consciousness, which includes not only the principle of Logos but also Eros.

• Neonatal Medicine
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• v.18 no.2
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• pp.404-408
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• 2011

Scimitar syndrome (SS) is a rare congenital anomaly characterized by hypoplasia of the right lung and partially anomalous pulmonary venous drainage to the inferior vena cava. The term scimitar derives from the shadow created by the anomalous pulmonary vein on chest X-ray that closely resembles that of a curved Turkish sword. It rarely presents as an isolated abnormality. Various cardiac and non-cardiac anomalies have been association with SS, such as right lung hypoplasia, dextroposition of the heart, hypoplasia of the right pulmonary artery, systemic arterial blood supply to the right lower lung from the infra-diaphragmatic aorta, and a secundum type of atrial septal defect. However, an imperforate anus has not been reported previously in association with SS. We describe the first case of infantile scimitar syndrome accompanied with an imperforate anus in a newborn who presented with tachypnea and right pulmonary atelectasis.

• Journal of radiological science and technology
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• v.18 no.2
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• pp.49-59
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• 1995

Recently, general radiography became to variety because of the continuous development of Inverter type generator and ortho chromatic system. Therefore, we must re-evaluate about patient exposure dose and image quality. I studied about chest radiography which has frequency among general radiography being used during FEB. to AUG., 1994 over 151 medical facilities from medical facilities that are located in Seoul area. The result obtained were as follows ; 1) The rectification method of the generator were employing mainly single phase full wave in 82.8 %, three phase full wave in 11.26 % and Inverter type in 4.64 % and condenser type is 1.32 %. 2) Exposure kV was used below 80 kV in most medical facilities and 21.8 % of the medical facilities was using high tube voltage higher than 120 kV. 3) The exposure time was used below the 0.05 sec in 28.4 %, in 29.8 % of the medical facilities used above 0.1 sec. 4) The usage frequency of the added filter is 15.3 %, and among them compound filter was used only 4 %. 5) Rare earth screen was used in 37.7 %. 6) The average skin entrance dose was 0.25 mSv, the range of dose is $0.05{\sim}0.79\;mSv$ in each medical facilities. 7) The average density of the lung field is 1.76, 0.49 in lung side, 0.30 in mediastinum and 0.37 in heart shadow. Therefore it is required to improve all of these for increasing image quality and reducing patient exposure dose as soon as possible.

• Journal of Chest Surgery
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• v.37 no.3
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• pp.286-291
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• 2004

Mediastinum is a very rare primary site of liposarcoma. In general, wide surgical excision with adequate resection margin is the treatment of choice for lipesarcoma. We experienced a case of liposarcoma in a 24 year-old male who complained of dyspnea and chest discomfort. Symptoms had been developed a month before admission, and the intensity had been gradually increased. He visited another general hospital, and there he received left closed thoracostomy because hemothorax was suspected. Afterwards, he was transferred to our hospital without a specific diagnosis, on review of outside chest computed tomography film, mass shadow was detected in the mediastinum. For the further evaluation, we checked the chest sonography and chest magnetic resonance imaging. MRI showed 10 cm sized mass contacted with pulmonary artery trunk and left main pulmonary artery. The radiologist strongly suggested sarcoma. On the 4th day after admission, we performed emergent exploratory left thoracotomy for hematoma evacuation because mediastinal shifting progressed and heart rate was increased. Biopsy confirmed that the evacuated materials were extraskeletal myxoid chondresarcoma, so we performed extrapleural left pneumonectomy including diaphragm and a part of the pericardium. The final pathologic diagnosis was myxoid/round cell liposarcoma. He was discharged without complication and systemic chemotherapy was scheduled to begin 2 month later. During chemotherapy, local recurrence and peritoneal metastasis developed, and he died 10 month after the surgical excision. We report this case with reviewal of literature.

• Clinical and Experimental Pediatrics
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• v.45 no.3
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• pp.383-389
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• 2002

We experienced a case of partial DiGeorge syndrome in a $35^{＋5}$ week premature female infant presented with micrognathia, fish-shaped mouth, beaked nose, nasal regurgitation, obstructive sleep apnea, velopharyngeal insufficiency and late onset hypocalcemic seizures. The chromosome 22q11 microdeletion was found by the FISH method. The lab findings showed serum calcium level of 4.4 mg/dL, ionized calcium level of 0.49 mg/dL, phosphorous level of 7.5 mg/dL, magnesium level of 1.3 mg/dL and PTH-RIA level of <1 pq/mL. Initial treatment was done with 10% calcium gluconate infusion and magnesium sulfate followed by oral calcium gluconate and low phosphorousformula milk feeding. The serum calcium level was normalized in 6 days. Nasal regurgitation, desaturation with obstructive sleep apnea continued. T-cell functions & numbers(CD 3, CD 4, CD 8)were decreased but Ig G/A/M levels were normal. No visible signs of thymus shadow were seen in either chest X-ray & chest MRI. Electrocardiography and echocardiography showed normal heart. Kidney ultrasonographby showed right side mild hydronephrosis. Neurosonography was normal but EEG showed electrical partial seizure. Hearing assessment by BERA showed mild to moderate hearing impairment. Velopharyngoplasty is scheduled for further treatment. A brief review of literature was made.

• Journal of Chest Surgery
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• v.34 no.10
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• pp.787-791
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• 2001

Coronary artery aneurysm is a rare disorder. It is defined as abnormal dilatation of coronary artery with diameter exceeding 1.5 times the adjacent normal segments. The incidence of coronary aneurysm is 2.6% in Caucasians and 0.25% in Asians. Over half of the former were associated with atherosclerotic coronary artery disease. However, 70 percents of the latter were nonobstructive coronary artery aneurysms. Coronary artery fistula is a rare disorder. It has been identified in only 0.2% of routine cardiac angiographic studies conducted over a 10-year period. The clinical spectrums are various, asymtomatic, asymptomatic murmur, dyspnea on exertion, fatigue, and congestive heart failure. The right coronary artery (56%) and left coronary artery(36%) are mainly involved in the origin site of congenital coronary artery fistula. The draining site of fistula are right ventricle(39%), right atrium(33%), and pulmonary artery(20%) and so on. This 54 years-old woman had intermittent chest tightness and an abnormal mediastinal shadow on chest roentgenogram and chest C-T examination, which was diagnosed as a mediastinal mass such as teratoma. We performed the operation under left anterolateral thoracotomy for mass excision. However, we knew the mass had the pulsating arterial blood flow through a fine needle puncture of the mass and that it was attached to the left ventricle. We believed the excision of mass on beating heart would be very dangerous. Therefore, we closed the wound without excising the mass. After several days, we performed an echocardiography and coronary angiography, We knew it was cardiac tumor. Incidentally, the patient had a tortuous coronary fistula from the right coronary artery to pulmonary trunk. Using cardiopulmonary bypass with moderate systemic hypothermia, the mass was resected and the fistula was clipped with surgical clips. Pathology of the specimen was a giant coronary arterial aneurysm.