• Advances in pediatric surgery
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• v.9 no.2
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• pp.89-93
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• 2003

A lipomatous lesion of the cord is an accidentally encountered structure during the operative repair of inguinal hernia. This lesion has been reported as a lipoma of the cord in adults. However, there is only a limited number of reports in the pediatric age group. To evaluate the prevalence of this lesion in children and in order to review the surgical signiticancies, 600 hernia operations in 411 children during a period of 4 years from January, 2000 to December, 2003 in the Division of Pediatric Surgery, Department of Surgery, the Catholic University of Korea, were included in this study. There was a total of 31 (5.2 %) lipomatous lesions in 25 (6.1 %) cases; 3 cases in infants, 17 between 1 to 4 years, and 5 above 5 years of age. Male was more prevalent (male to female ratio 14:11). The laterality of clinical hernia with the lesions was 10 in the right, 13 in the left and 2 in both sides. The patients with ipsilateral lesions to the hernia were 14, contralateral in 5 and bilateral in 6 cases. Excluding 1 case of bilateral lesions in bilateral hernia, 10 lesions were contralateral to the clinical hernias. In 1 case, lipomatous lesion was the sole finding with nonsignificant patent processus vaginalis. Every lesion was suture ligated and resected with gentle traction of the dissected hernia sac. It has not been clearly defined whether the lesion is a stopper or a provocator of the hernia development. However, removal is highly recommended to make a differential diagnosis from the recurrent inguinal hernia in future. The term "lipomatous lesion" seems to be pathologically accurate and must be differentiate from the true lipomas.

• Journal of Veterinary Clinics
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• v.20 no.3
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• pp.357-363
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• 2003

These studies were carried out to develop non-contact thermometer to take easily the body temperature of domestic animals instead of taking rectal temperature. For the studies, 86 cattle, 57 horses, 72 pigs, 43 goats, and 42 dogs were used and body parts as neck, flank, axilla, lateral abdomen, gluteus, inguinal region, or jugular groove were chosen for taking temperature according to different species. Two types of commercial non-contact thermometers were used to take the temperature of certain body part and at the same time the rectal temperature using digital thermo-meter was taken to compare the difference of temperature between rectum and certain body part. The difference of mean temperature in cattle between rectum and axilla and flank were 0.52 and $2.41^{\circ}C$, respectively, using non-contact thermometer I, whereas $3.02^{\circ}C$ between rectum and flank using thermometer II. The difference of mean temperature in horses between rectum and axilla, gluteus, and jugular groove were 0.52, 1.49, and $0.26^{\circ}C$, respectively, using thermometer I, whereas 2.28 ane $0.92^{\circ}C$ between rectum and gluteus or jugular groove using thermometer II. The difference of mean temperature in swine between rectum and flank, inguinal region, and neck were 1.23, 0.21, and $0.8^{\circ}C$, respectively, using thermometer I, whereas 1.42, 0.711, and $1.25^{\circ}C$ using thermometer II The difference of mean temperature in goats between rectum and lateral abdomen and inguinal region were 1.02 and $0.12^{\circ}C$, respectively, using thermometer I, whereas 1.96 and $1.01^{\circ}C$ using thermometer II. The difference of mean temperature in dogs between rectum and lateral abdomen, inguinal region, and neck were 3.26, 0.24, and $2.37^{\circ}C$, respectively, using thermometer I, whereas 3.45, 0.56, and $2.61^{\circ}C$ using thermometer II.

• Advances in pediatric surgery
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• v.16 no.2
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• pp.101-107
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• 2010

Herniorrhaphy of Indirect inguinal hernia (IIH) is one of the most frequently performed surgical procedures in children. The overall incidence of inguinal hernias in childhood ranges from 0.8 to 4.4 %. The incidence is up to 10 times higher in boys than girls, especially much higher in premature infants. IIHs in children are basically an arrest of embryologic development rather than an acquired weakness, which explains the increased incidence in premature infants. In normal development, the processus vaginalis closes, obliterating the peritoneal opening of the internal ring between 36th and 40th week of gestation. This process is often incomplete, leaving a small patent processus in many newborns. However, closure continues postnatally, and the rate of patency is inversely proportional to age of the child. The presence of a patent processus vaginalis is a necessary but not sufficient variable in developing a congenital IIH. In other words, all congenital IIHs are preceded by a patent processus vaginalis, but not all patent processus vaginalis go on to become IIHs. The overall incidence of IIH in population is approximately 1 to 2 % and the incidence of a processus vaginalis is approximately 12 to 14%, clinically appreciable IIH should develop in approximately 8 to 12 % of patients with a patent processus vaginalis. Although the classic open inguinal hernia repair remains the gold standard for most pediatric surgeons, laparoscopic repair is being performed in many centers. Like open technique, laparoscopic technique is fundamentally a high ligation of the indirect hernia sac with or without internal ring ligation. The advantages of laparoscopic approach include the ease of examining the contralateral internal ring, the avoidance of access damage to vas and vessels during mobilization of cord, decreased operative time, and an ability to identify unsuspected direct or femoral hernias. Almost all groin hernias in children are IIHs and occur as a result of incomplete closure of processus vaginalis. The treatment is repair by high ligation of hernia sac, which can be done by an open or laparoscopic technique. The contralateral side can be explored by laparoscopy or left alone, open exploration is no longer indicated due to potential risk of infertility.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.847-849
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• 2010

Purpose: Traditional radical surgery for vulvar cancer produces severe skin and soft tissue defects in the vulvar and vaginal area. Vulvoperineal V-Y advancement fasciocutaneous flaps have limitations in advancement and tension at the wound margin and vaginal orifice area, causing wound disruption or vaginal wall exposure. Therefore, we designed the "Butterfly flap" using a vulvoperineal V-Y advancement fasciocutaneous flap and an inguinal rotational skin flap for 3-dimensional reconstruction of vagina and vulvar area. Methods: A 27 year-old female was diagnosed with vulvar intraepithelial neoplasia. Radical vulvectomy and full-thickness-skin-graft was performed. We designed a vulvoperineal V-Y advancement fasciocutaneous flap as the greater wing and inguinal rotational skin as the lesser wing. After flap elevation, the inguinal flap was rotated $180^{\circ}$ to reconstruct the labia major and vaginal orifice. The perineum was reconstructed using V-Y advancement flaps. Results: The flap survived completely, without any complications. After 6 months, the patient was able to perform normal sexual activities and after 18 months, the patient was able to give birth to normal child by caesarean section. Conclusion: The traditional vulvoperineal V-Y advancement fasciocutaneous flap is thin, reliable, easily elevated and matches local skin quality. However, the vaginal wall becomes exposed due to limited advancement and tension of the flap. The "Butterfly flap" using a vulvoperineal V-Y advancement fasciocutaneous flap and an inguinal rotational skin flap is useful for the release of vaginal orifice contracture, reconstruction of the labia major, and 3-dimensional reconstruction of vagina and vulvar area.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.213-217
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• 2000

Background: This study was conducted to evaluate and compare the effectiveness of intravenous ketorolac and wound infiltration in producing postherniorrhaphy analgesia in pediatric surgery. Methods: Forty consenting healthy children, aged 3~7 yr, were randomly assigned to receive intravenous ketorolac (1 mg/kg) or wound infiltration (0.25% bupivacaine 0.3 ml/kg) before closure of the surgical wound after inguinal herniorrhaphy. Pain was evaluated by using an observer pain score at 30 min, 60 min and 4 hrs intervals, postoperatively. Results: It is statistically significant that the wound infiltration group had lesser pain than the ketorolac group at 30 min and 60 min. But there is no difference between the groups at 4 hrs, postoperatively. Conclusions: We concluded that wound infiltration may provide better analgesia compared to intravenous ketorolac for up to 4 hours postoperative for treatment of pain after inguinal herniorrhaphy in pediatric surgery.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.2
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• pp.233-237
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• 2014

This case report that the therapeutic effects of traditional Korean medicine(TKM) treatment on the tumor response in a diffuse large B-cell lymphoma(DLBL) patient. A patient was treated by acupuncture, pharmacopuncture, moxibustion, cupping and herbal medicine once a week at least for 12 months. we evaluated the grade of chief complaints and performed blood tests and sonography, abdominal CT periodically. After 1 month administration with TKM treatment, the symptoms of the patient vanished obviously. the size of inguinal lymphoma decreased gradually through 3 months. then from 3 to 10 months, the size of inguinal lymphoma remained as it is. TKM treatment was maintained continuously. in the abdomino-pelvic CT performed after 12 months, the patient didn't complain any symptom and the size of inguinal lymphoma decreased a little again. This case study supports that TKM treatments may have a efficacy in treating diffuse large B-cell lymphoma(DLBL) patients.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.101-104
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• 2009

Purpose: Subungual squamous cell carcinoma is a very rare malignant tumor of the digitus especially in toe making it very difficult to differentiate with tinea unguium, verruca vulgaris, eczema, pyogenic granuloma, and malignant melanoma due to their clinical similarities. Therefore this article reports on subungual squamous cell carcinoma of left 5th toe. Methods: A patient visited at our hospital due to pain and incurable inflammation on left 5th toe with no improvement for four months. Despite of antibiotics and dressing for a week, treatment was ineffective. After excisional biopsy, he was diagnosed with subungual squamous cell carcinoma. And ray amputation and prophylactic inguinal lymph node dissection was done. Results: The biopsy was showed irregular cells made up of anaplastic and squamous cells in the dermis and epidermis. And the inguinal lymph node showed no metastatsis. The patient had been treated without significant complications and recurrence for a year. Conclusion: This article emphasizes the need of diagnostic biopsy on the subungual lesions that have resistance to the conventional treatments. And if that is subungual squamous cell carcinoma, complete resection of the lesion and prophylactic inguinal lymph node dissection is essential.

• Parasites, Hosts and Diseases
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• v.50 no.4
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• pp.353-355
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• 2012

We report here a case of inguinal sparganosis, initially regarded as myeloid sarcoma, diagnosed in a patient undergone allogeneic hematopoietic transplantation (HSCT). A 56-year-old male patient having myelodysplastic syndrome was treated with allogeneic HSCT after myeloablative conditioning regimen. At day 5 post-HSCT, the patient complained of a painless palpable mass on the left scrotum and inguinal area. Pelvic magnetic resonance imaging and computed tomography revealed suspected myeloid sarcoma. Gun-biopsy was performed, and the result revealed eosinophilic infiltrations without malignancy. Subsequent serologic IgG antibody test was positive for sparganum. Excisional biopsy as a therapeutic diagnosis was done, and the diagnosis of sparganosis was confirmed eventually. This is the first report of sparganosis after allogeneic HSCT mimicking myeloid sarcoma, giving a lesson that the physicians have to consider the possibility of sparganosis in this clinical situation and perform adequate diagnostic and therapeutic approaches.

• Advances in pediatric surgery
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• v.20 no.2
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• pp.23-27
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• 2014

Purpose: Laparoscopic hernia repair in children is still controversial. The aim of this study was to report our long-term results of the laparoscopic hernia technique, which is based on the same surgical principles as conventional open herniotomy. Methods: Five hundred fourteen pediatric patients with inguinal hernia were included in this study under informed consent. All patients underwent a laparoscopic technique of sac transection and intracorporeal ligation. The asymptomatic contralateral inguinal ring was routinely explored and repaired if a patient had patent processus vaginalis on the contralateral side. Patients were prospectively followed for 5 years. Those who were lost to follow-up were excluded from the study. Perioperative complications and recurrences were evaluated. Results: The mean follow-up period was 29 months. Mean operation time was 27.5 minutes. Forty one percent of the patients had contralateral patent processus vaginalis. Only one hernia recurred (0.19%). We had one case of contralateral metachronous hernia (0.21%) during follow-up period. Conclusion: The long-term follow-up results of our study revealed that laparoscopic hernia sac transection and ligation can be a safe and effective alternative for conventional herniorraphy.

• Journal of Yeungnam Medical Science
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• v.7 no.1
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• pp.127-131
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• 1990

Pediatric caudal anesthesia was done in 50 infants and children under 10 years of age, who were to undergo surgery of inguinal region. All cases were given 10mg/kg body weight of 1% lidocaine solution with epinephrine 1:200,000. The results were as follows : 1) Pediatric caudal anesthesia was simple, easy and reliable in technique. 2) Additional intravenous administration of Ketamine or pentothal sodium was needed. ie, to provide a more cooperative state. 3) Anesthetic effect was judged very Excellent. 4) Cardiovascular and respiratory changes were minimal. Author's came to conclusion that caudal anesthesia for pediatric inguinal region surgery is reliable, simple in technique, favorable to surgeon, and is considered to be a good technique for pediatric anesthesia.