• Journal of Chest Surgery
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• 제35권12호
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• pp.902-905
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• 2002

폐엽절제술은 종종 장기간의 공기누출을 초래하기도 한다. 결핵 및 만성폐쇄폐질환으로 치료중인 환자가 우측폐 하엽에 편평상피세포암종이 발견되어 우측 양엽 절제술을 시행하였다. 수술 후 21일까지 지속되는 공기누출과 이에 따른 사강이 해결되지 않아 소아용 도관을 이용하여 인공기복을 만들었다. 인공기복술 직후 공기누출이 감소하여 23일째 멈추었고 수술 후 25일째 흉관을 제거할 수 있었다.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2009년도 춘계학술대회
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• pp.305-305
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• 2009

• 대한후두음성언어의학회지
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• 제27권1호
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• pp.54-57
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• 2016

Percutaneous dilatational tracheostomy (PDT) has become an increasingly popular method of establishing an airway for patients in need of chronic ventilator assistance. We report a rare case of a 42-year-old female who developed extensive subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum, and pneumoperitoneum after percutaneous dilatational tracheostomy. The patient suffered from amyotrophic lateral sclerosis, and underwent PDT after a period of mechanical ventilation. During PDT, tracheostomy tube was inserted into the paratracheal space. Follow-up chest radiography and computed tomography of chest and abdomen revealed extensive subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum, and pneumoperitoneum. The patient was treated successfully with insertion of the thoracostomy tube and conservative care.

• 한국임상수의학회지
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• 제31권4호
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• pp.333-336
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• 2014

An 1-year-old, intact female Yorkshire Terrier weighing 1.83 kg was referred for vomiting and anorexia. Survey abdominal radiographs revealed marked gastric distention. Ultrasonography showed a hyperechoic material with acoustic shadowing near the pylorus. A foreign body and ulceration were identified during gastroscopic examination. After endoscopic retrieval of gastric foreign body, unexpectedly abdominal distention was developed. Abdominal radiographs revealed pneumoperitoneum, but no leakage of contrast media was observed in gastrointestinal contrast study. Three days after hospitalization with supportive care, no abnormal findings were detected, and then the dog was discharged. This case describes the development of peumoperitoneum during endoscopic retrieval of gastric foreign body.

• 한국임상수의학회지
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• 제28권1호
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• pp.40-45
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• 2011

Cardiovascular changes caused by $CO_2$ pneumoperitoneum during laparoscopic ovariohysterectomy (LOVH) were measured in nine healthy mixed breed dogs ($16.7{\pm}4.6kg$). The dogs were premedicated with the combination of atropine, acepromazine, and butorphanol. General anesthesia was induced with propofol and maintained with isoflurane in oxygen. Controlled ventilation maintained partial pressure of end-tidal $CO_2$ between 35-45 mmHg. The $CO_2$ pneumoperitoneum was maintained at a constant pressure of 12 mmHg and the dog was placed in the $15^{\circ}$ Trendelenburg position as LOVH was performed. Dorsal pedal artery was catheterized for measurements of heart rate (HR) and invasive arterial blood pressure (IBP). Prior to the intraperitoneal insufflation, baseline measurements of HR and IBP were made every minute for a total of 10 min. Then, measurements of HR and IBP were made every 5 min following intraperitoneal insufflation and were also made every 5 min following desufflation for a total of 10 min. The $CO_2$ pneumoperitoneum during LOVH resulted in a significant (P < 0.05) increase in systolic arterial blood pressure at the time of the onset of insufflation. In addition, diastolic and mean arterial blood pressure increased significantly (P < 0.05) at the time of the onset of insufflation and 5 min following insufflation. The mean heart rate did not change significantly during LOVH. Although IBP showed sharp initial rise following the $CO_2$ pneumoperitoneum, the changes were within physiological acceptable limits in these healthy, ventilated dogs.

• 한국임상수의학회지
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• 제10권1호
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• pp.19-35
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• 1993

These studies performed to establish the diagnostic methods for the luminal adhesions to abdominal wall with radiography, ultrasonography and electromyography, and to evalute sodium carboxymethylcellulose(SCMC) for prevention of the abdominal adhesions in goats. The adhesion sites were not detected by rediography and ultrasonography at non-pneumoperitoneum, but detected after pneumoperitoneum in goats with experimentally induced ruminal abhesions to abdominal wall. Electromyography revealed only the presence of intraabdominal adhesions. In fibriongen values and total leucocytes, there were no alterations between SCMC treated and non-treated group. The average gross scores of adhesions in SCMC treated and non-treated were 0.3 and 2.7, respectively. It was concluded that radigraphy, electromyography and ultrasonography could be available for the diagnosis of the ruminal adhesions to abdominal wall and the use of SCMC was useful to prevent the intraabdominal adhesions in ruminants.

• Advances in pediatric surgery
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• 제14권2호
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• pp.144-152
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• 2008

Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in the neonatal population. The aim of this study is to evaluate surgical indication and prognostic factors of NEC. Clinical data of seventy patients, diagnosed as NEC between January 2000 & January 2007, were reviewed retrospectively. Fifty-seven patients had medical treatment and 7 of them died. Thirteen patients who presented with pneumoperitoneum on plain abdominal film or were refractory to medical treatment received surgical treatment, and 5 of them died. All the expired 12 patients weighed less than 2500 g. Twenty out of seventy patients showed thrombocytopenia, and 11 patients of them died. The finding of pneumoperitoneum and thrombocytopenia could be the most important surgical indication. Prematurity, low birth weight and thrombocytopenia were related to a bad prognosis. NEC patients who presents with these findings must be considered for close observation and intensive care.

• Tuberculosis and Respiratory Diseases
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• 제51권6호
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• pp.585-589
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• 2001

저자들은 심한 천식발작으로 내원한 43세 여자환자에서 응급 기관내 삽관 및 AMBU 양압환기에 종격동기흉, 복강기종, 후복강기종 및 피하기종이 합병되었으나 내과적 치료로 회복된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 한국산학기술학회논문지
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• 제16권5호
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• pp.3303-3307
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• 2015

본 연구는 74세 여자 환자가 심정지 후 일반인과 119구급대원들에게 시행된 심폐소생술의 합병증인 기복증에 대한 증례를 경험하였기에 이에 대한 임상양상과 병태생리를 조사하기 위해 시도되었다. 평소 건강했던 74세 여자가 식당에서 일하던 중 갑자기 발생한 의식저하로 쓰러졌다. 증상발생 후 즉시 119에 신고를 하였고 현장에서 목격자에 의한 즉각적인 심폐소생술이 시행되었으며, 현장에 도착한 119구급대원에 의한 심폐소생술과 제세동이 시행된 결과 자발순환을 회복하였다. 자발순환 회복 후 환자는 인근 2차병원으로 이송되어 시행한 심전도 검사에서 급성심근경색이 의심되어 추가적인 검사와 치료를 위해 3차병원으로 이송되었다. 이후 시행한 X-ray 검사와 복부전산화 단층촬영 검사결과 위문접합부의 파열과 다량의 기복증을 보여 수술치료를 결정하였으나 수술실에서 다시 심정지가 발생하여 심폐소생술을 시행하였으나 환자는 결국 사망하였다. 따라서 병원 전 현장에서 심폐소생술을 시행 할 때 흉부압박의 정확한 위치 선정이 필요하며 양압 환기에 대한 신중한 고려가 필요하겠다. 또한 심폐소생술 후 발생한 기복증의 치료는 환자의 혈역학적 상태를 충분히 고려해야 할 것으로 사료된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권3호
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• pp.193-198
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• 2016

Purpose: Spontaneous colon perforations are usually encountered as necrotizing enterocolitis in the neonatal period, but occur rarely in infants and children without pathological conditions. This study was conducted to describe its clinical implication beyond the neonatal period. Methods: Cases of spontaneous colon perforation confirmed after the operation were reviewed retrospectively and the clinicopathological characteristics were analyzed. Clinical data were compared according to the presence of pneumoperitoneum as initial findings. Results: Eleven patients were included in the study period and showed a history of hospitalization before transfer due to management for fever, respiratory or gastrointestinal problems. Six patients showed a sudden onset of abdominal distention and only seven patients showed a pneumoperitoneum as initial radiologic findings, however there were no significant clinicopathological differences. Perforation was found evenly in all segments of the colon, most commonly at the sigmoid colon in four cases. There were no specific pathologic or serologic causes of perforation. Conclusion: When previously healthy infants and children manifest a sustained fever with a sudden onset of abdominal distention during management for fever associated with respiratory or gastrointestinal problems, there is a great likelihood of colon perforation with no pathological condition. Prompt surgical management as timely decision-making is necessary in order to achieve a good progress.