• Korean Journal of Radiology
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• v.23 no.2
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• pp.271-279
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• 2022

Objective: To compare the clinical and radiologic findings between perforated and non-perforated choledochal cysts in children. Materials and Methods: Fourteen patients (mean age ± standard deviation, 1.7 ± 1.2 years) with perforated choledochal cysts (perforated group) and 204 patients (3.6 ± 3.8 years) with non-perforated choledochal cysts (non-perforated group) were included between 2000 and 2019. All patients underwent choledochal cyst excision after ultrasound, CT, or MR cholangiopancreatography. Relevant data including demographics, clinical symptoms, laboratory findings, imaging findings, and outcomes were analyzed. Statistical differences were compared using the Mann-Whitney U test and Fisher's exact test. Results: Choledochal cyst perforation occurred only in children under the age of 4 years. Acute symptoms, including fever (p < 0.001), were more common in the perforated group than in the non-perforated group. High levels of white blood cells (p = 0.004), C-reactive protein (p < 0.001), and serum amylase (p = 0.002), and low levels of albumin (p < 0.001) were significantly associated with the perforated group. All 14 patients with perforated choledochal cysts had ascites, whereas only 16% (33/204) of patients in the non-perforated group had ascites (p < 0.001). In the subgroup of patients who had ascites, a large amount of ascites (p = 0.001), increase in the amount of ascites in a short time (p < 0.001), complex ascites (p < 0.001), and perihepatic pseudocysts (p < 0.001) were more common in the perforated group than in the non-perforated group. Conclusion: Children with perforated choledochal cysts have characteristic clinical and radiologic findings compared to those with non-perforated choledochal cysts. In young children with choledochal cysts, perforation should be differentiated in cases with acute symptoms, laboratory abnormalities, and characteristic ascites findings.

• Applied Microscopy
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• v.12 no.1
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• pp.1-10
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• 1982

Serous otitis media is closely related with auditory tube function, but its etiology and pathogenesis are not clearly defined yet. So we tried to prove the theory of hydrops ex vacuo via the experimental study with cats by means of obstructing the pharyngeal orfice of the auditory tube and observe the serial changes in tympanic mucosa through light and electron microscopy. The results are as follows; 1. We confirmed the production of serous otitis media with auditory tube obstruction and have a new understanding of auditory tube function in middle ear aeration. 2. The effusion in serous otitis media was produced from the next day of experiment and increased till the fourteenth day, but decreased after the spontaneous perforation of ear drum. 3. Through the light microscopy, we observed the increasement of the sercretory cells including goblet cells, epithelial hyperplasia, capillary proliferation and invasion of inflammatory cells. 4. Through the elctron microscopy, we observed the protrusion of secretory cells, blobs in cilia, loss of cilia, increasement of vesicles, vacuoles and dense bodies in ciliated cells and Invasion of inflammatory cells. With above results, we concluded that aeration through auditory tube is the most important factor in serous otitis media and presumed the effusion was secreted by secretory cells.

• Journal of Gastric Cancer
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• v.13 no.1
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• pp.65-68
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• 2013

Gastric carcinoma rarely presents as a perforation, but when it does, is perceived as advanced disease. The majority of such perforations are Stage III/IV disease. A T1 gastric carcinoma has never been reported to perforate spontaneously in English literature. We present a 56 year-old Chinese male who presented with a perforated gastric ulcer. Intra-operatively, there was no suspicion of malignancy. At operation, an open omental patch repair was performed. Post-operative endoscopy revealed a macroscopic Type 0~III tumour and from the ulcer edge biopsy was reported as adenocarcinoma. Subsequently, the patient underwent open subtotal gastrectomy and formal D2 lymphadenectomy. The final histopathology report confirms T1b N0 disease. The occurrence of a perforated early gastric cancer reemphasises the need for vigilance, including intra-operative frozen section and/or biopsy, as well as routine post-operative endoscopy for all patients.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.127-131
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• 2013

Urinomas can occur after renal trauma or perforation of the collecting system during an endosurgical procedure. However, spontaneous urinomas are very rare. Here we report a case of a spontaneous perinephric urinoma following the removal of a Foley catheter in an 18-year-old girl with acute kidney injury caused by septic shock. The patient had been treated for septic shock, acute kidney injury, and acute respiratory distress syndrome, and had a Foley catheter in place for seven days. After Foley catheter removal, the patient complained of consistent voiding difficulty. An abdominal computed tomography scan showed a large amount of left perinephric fluid, and the aspirated fluid included urothelial cells, confirming the diagnosis of a urinoma. The urinoma was successfully treated by insertion of a double-J stent into the left ureter. This report discusses the available literature on urinomas, and their clinical features, diagnosis, and treatment.

• Journal of Chest Surgery
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• v.29 no.10
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• pp.1123-1128
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• 1996

A clinical study was performed on 152 cases of surgical esophageal disease treated by the Department of Thoracic & Cardiovascular Surgery of Korea University Hospital from Jan. 1989 through July 1994. The most common esophageal disease was cancer which was seen in 73 cases (48%) among 152 cases. All were treated surgically' 52 patients (71%) were managed by curative or palliative resection with reconstruction and feeding gastrostomy or jejunostomy, otherwise Celestine tube insertion was performed on the remaining 21 patients for palliatio'n. Esophageal leiomyoma occurred in 6 cases(3.9%), among them 1 case was performed with trio recoscopic enucleation . Achalasia were in 7 cases (4.6%) and was treated with modified Heller's m otomy and with Belsey Mark IV operation. Diverticulum were in 11 cases (7.2%). Esophageal stricture occurred in 20 cases (14.1 %) and 17 of 20 cases were managed with bypass surgery. Esophageal perforation was seen in 20 cases, its cause was instrumental trauma in 7 cases, stab wound in 4 cases, foreign body in 4 cases, spontaneous perforation in 3 cases, and others 1 case Other disease including congenital lesion was seen In 1 Scases.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.5
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• pp.3303-3307
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• 2015

The purpose of this study was attemped to investigate the clinical presentation and pathophysiology of 74-year-old female who developed pneumoperitoneum as complications of chest compression from sudden cardiac arrest. Such chest compression is the same one excercised to by-stander and paramedics. A healthy 74 year female had a sudden mental deterioration while working at a restaurant. She was transfered from 119 emergency medical system to the hospital. After the symptom developed, by-stander called 119 who carry out 6 minutes Cardiopulmonary resuscitation(CPR). Defibrillation and CPR was carried out by health provider after the arrival, and the patients spontaneous circulation returned. After Return of spontaneous circulation(ROSC), patients was transferred to the nearst hopspital, but suspicious of myocardial infarction, she was again transferred to a larger scale hospital. At the hospital she took X-rays and Abdominal CT, and the results of suspicious gastro-intestinal perforation near gastro-esophageal junction, surgical repair was recommended. But in operation room, while operation went on, cardiopulmonary arrest appeared again, and she expired. For this reason, prehospital CPR needs more accurate localization of cardiac massage and serious consideration of positive pressure ventilation. Moreover, treatment of pneumoperitoneum after CPR needs more cautious consideration of patients hemodynamic stability.