• Title/Summary/Keyword: Mesenteric approach

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Systemic Classification for a New Diagnostic Approach to Acute Abdominal Pain in Children

  • Kim, Ji Hoi;Kang, Hyun Sik;Han, Kyung Hee;Kim, Seung Hyo;Shin, Kyung-Sue;Lee, Mu Suk;Jeong, In Ho;Kim, Young Sil;Kang, Ki-Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.4
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    • pp.223-231
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    • 2014
  • Purpose: With previous methods based on only age and location, there are many difficulties in identifying the etiology of acute abdominal pain in children. We sought to develop a new systematic classification of acute abdominal pain and to give some helps to physicians encountering difficulties in diagnoses. Methods: From March 2005 to May 2010, clinical data were collected retrospectively from 442 children hospitalized due to acute abdominal pain with no apparent underlying disease. According to the final diagnoses, diseases that caused acute abdominal pain were classified into nine groups. Results: The nine groups were group I "catastrophic surgical abdomen" (7 patients, 1.6%), group II "acute appendicitis and mesenteric lymphadenitis" (56 patients, 12.7%), group III "intestinal obstruction" (57 patients, 12.9%), group IV "viral and bacterial acute gastroenteritis" (90 patients, 20.4%), group V "peptic ulcer and gastroduodenitis" (66 patients, 14.9%), group VI "hepatobiliary and pancreatic disease" (14 patients, 3.2%), group VII "febrile viral illness and extraintestinal infection" (69 patients, 15.6%), group VIII "functional gastrointestinal disorder (acute manifestation)" (20 patients, 4.5%), and group IX "unclassified acute abdominal pain" (63 patients, 14.3%). Four patients were enrolled in two disease groups each. Conclusion: Patients were distributed unevenly across the nine groups of acute abdominal pain. In particular, the "unclassified abdominal pain" only group was not uncommon. Considering a systemic classification for acute abdominal pain may be helpful in the diagnostic approach in children.

승모판 협착증의 외과적 요법

  • 이영균
    • Journal of Chest Surgery
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    • v.4 no.1
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    • pp.11-24
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    • 1971
  • Eighty-four cases of mitral commissurotomy were done in this department between October 1958 and September 1970. Therc wcre 54 males and 30 females. Six cases were under the age of 20 years. Prcoperativc embolization occurred in 9. 5% of the cases. consisting of 8. 3% cerebral and 1.2% peripheral embolization. Intraoperative and postoperative cmbolization occurred in 4.7% of the cases, with 1. 2% cerebral and 3.5% peripheral embolism. Two out of three postopeative embolism cases expired, one of which was caused by septic cerebral embolism due to valve vegetation nnd the other by mesenteric embolism. Atrial fibrillation was 1loted ill 43% of the case. Seventy closed mitral commissurotomy was done by left appendegeal approach with finger fracture method or Bailey's guillotine valvotome. Fourteen open mitral commissurotomy cases were done either by right side approach or median sternotomy, three of which were reoperation cases after blind mitral commissurotomy. One out of 14 cases were operated on with open mitral commissurotomy and concomitant open aortic valve bicuspidalization, This case expired due to severe serum hepatitis ten days after operation. Thirty-two per cent of valve calcification was noted during operation and one of which had marked vegetation on the valve cusps too. Operative mortality was 1.4% in blind mitral commissurotomy and 14% in open mitral commissurotomy. Over-all mortality in the entire series was 3.5%. One case among the blind commissurotomy cases expired during operation due to left inferior pulmonary vein laceration and death was caused in two open mitral commissurotomy cases by coronary artery airembolism. Three hospital death occurred in blind operation group, one due to coronary embolism, and two by hepatic failures. Three hospital death among open heart surgery cases were caused by hepatic failure in two and cerebral embolism in one cases. ln most of the survivors improved functional capacity and exercise lolerance were noted.

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A Case of Belsey Mark IV Fundoplication after Failed Nissen Antireflux Surgery (실패한 Nissen 술을 Belsey Mark IV 위바닥주름술로 교정한 1예)

  • Shon, Su Min;Shin, Hyun Jung;Park, Moon Ho;Keum, Dong Yoon;Park, Chang Kwon;Choi, Won Joung;Kim, Ae Suk;Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.1
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    • pp.103-107
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    • 2006
  • Antireflux surgery has been indicated in gastroesophageal reflux disease (GERD) that does not respond to medical treatments. Although the most commonly performed operation is Nissen fundoplication, Belsey Mark IV fundoplication is indicated for more complicated cases, such as, in cases of a failed Nissen operation or a long lasting hiatal hernia. Here, we report a case of Belsey Mark IV fundoplication for a failed Nissen fundoplication. The infant developed frequent times of aspiration pneumonia after initial Nissen for a hiatal hernia with GERD during the newborn period. At 15 months of age, a $2^{nd}$ Nissen operation was attempted, but fundoplication was not available because of excessive mesenteric adherence to the liver and cardia. Therefore, Belsey Mark IV fundoplication was performed via trans-thoracic approach, which can provide full esophageal mobilization and better visualization of the herniated fundus and the surrounding tissues. Subsequently, she has shown an improved general condition without GERD.

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Two Different Causes of Intestinal Obstruction in Lung Cancer (폐암 환자에서 발생한 장 폐색 2예)

  • Han, Min Sung;Koh, Kyung Won;Kim, Yeo Myung;Kang, Min Soo;Choe, Du Hwan;Kim, Hye-Ryoun;Kim, Cheol Hyeon;Lee, Jae Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.5
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    • pp.365-369
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    • 2009
  • Prompt and proper discovery of cause is important in lung cancer patients with signs and symptoms of intestinal obstruction because approach for treatment may differ according to its etiology and emergency operation can often be required to prevent more severe complications. In this report, we present two different causes of intestinal obstruction in lung cancer. Physicians need to be aware of these possibilities to differentiate the cause of intestinal obstruction in patients with lung cancer.

Immunomodulatory Properties of Lactobacillus plantarum NC8 Expressing an Anti-CD11c Single-Chain Fv Fragment

  • Liu, Jing;Yang, Guilian;Gao, Xing;Zhang, Zan;Liu, Yang;Yang, Xin;Shi, Chunwei;Liu, Qiong;Jiang, Yanlong;Wang, Chunfeng
    • Journal of Microbiology and Biotechnology
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    • v.29 no.1
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    • pp.160-170
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    • 2019
  • The lactic acid bacteria species Lactobacillus plantarum (L. plantarum) has been used extensively for vaccine delivery. Considering to the critical role of dendritic cells in stimulating host immune response, in this study, we constructed a novel CD11c-targeting L. plantarum strain with surface-displayed variable fragments of anti-CD11c, single-chain antibody (scFv-CD11c). The newly designed L. plantarum strain, named 409-aCD11c, could adhere and invade more efficiently to bone marrow-derived DCs (BMDCs) in vitro due to the specific interaction between scFv-CD11c and CD11c located on the surface of BMDCs. After incubation with BMDCs, the 409-aCD11c strain harboring a eukaryotic vector pValac-GFP could lead to more efficient expression of GFP compared with wild-type strains shown by flow cytometry analysis, indicating the enhanced translocation of pValac-GFP from L. plantarum to BMDCs. Similar results were also observed in an in vivo study, which showed that oral administration resulted in efficient expression of GFP in both Peyer's patches (PP) and mesenteric lymph nodes (MLNs) within 7 days after the last administration. In addition, the CD11c-targeting strain significantly promoted the differentiation and maturation of DCs, the differentiation of $IL-4^+$ and $IL-17A^+$ T helper (Th) cells in MLNs, as well as production of $B220^+$ $IgA^+$ B cells in the PP. In conclusion, this study developed a novel DC-targeting L. plantarum strain which could increase the ability to deliver eukaryotic expression plasmid to host cells, indicating a promising approach for vaccine study.

A regression for estimating metabolizable glucose in diets of weaned piglets for optimal growth performance

  • Lv, Liangkang;Feng, Zhi;Zhang, Dandan;Lei, Long;Zhang, Hui;Liu, Zhengya;Ren, Ying;Zhao, Shengjun
    • Animal Bioscience
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    • v.34 no.10
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    • pp.1643-1652
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    • 2021
  • Objective: Two experiments were conducted to provide a new approach for evaluating feed nutritional value by metabolizable glucose (MG) in piglet diets with different levels of starch and crude fiber. In Exp 1, a regression equation for MG was generated. In Exp 2, the equation was verified, and the optimal growth performance of piglets under appropriate MG levels was tested. Methods: In Exp 1, 20 weaned piglets (7.74±0.81 kg body weight [BW]) were randomly assigned to 1 of 4 treatments, including the basal diet containing different levels of MG (starch, 25.80%, 31.67%, 45.71%, 49.36%; crude fiber, 1.23%, 1.35%, 1.80%, 1.51%). The piglets were implanted with an ileal fistula, cannulation of the carotid artery, portal vein, and mesenteric artery. The chyme from the ileum fistula and blood samples were collected. In Exp 2, 30 weaned piglets (8.96±0.50 kg BW) were randomly assigned to 1 of 5 treatments, including the experimental diets with different levels of MG (37.6, 132.5, 300.0, 354.3, and 412.5 g/kg). The piglets' BW, and feed consumption were recorded to calculate growth performance during the 28-d experiment. Results: In Exp 1, the MG levels in 4 diets were 239.62, 280.68, 400.79, and 454.35 g/kg. The regression equation for the MG levels and dietary nutrients was: Y (MG) = 12.13×X1 (starch)+23.18×X2 (crude fiber)-196.44 (R2 = 0.9989, p = 0.033). In Exp 2, treatments with 132.5 and 300.0 g/kg MG significantly (p<0.05) increased average daily gain and feed conversion efficiency of weaned piglets, increased digestibility of crude fat, and had no effect on digestibility of crude protein compared to 300.0 to 412.5 g/kg MG. Conclusion: The pig model combining the ileum fistula and cannulation of blood vessels was successfully used to determine the dietary MG levels. The recommended MG level in weaned pig diets is 132.5 to 300.0 g/kg.