• Advances in pediatric surgery
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• v.9 no.1
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• pp.19-23
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• 2003

Necrotizing Enterocolitis (NEC) is usually a disease of premature infants, but occasionally it affects the term neonate. Twenty-five infants with NEC were treated at Asan Medical Center between January 2000 and December 2002, and 13 of them were term infants. In each case, the diagnosis of NEC was established by a clinical illness fulfilling the Bell's stage II or III NEC as modified by Walsh or by surgical findings. There were six males and seven females. The birth weight was from 1,960 to 3,700 g. The age at diagnosis was from 1 to 40 days. Four patients had congenital heart disease: one of who had hypothyroidism and cleft palate. Abdominal distension was present in all, and bloody stools in four. One patient had history of hypoglycemia, three had Rota viral infection. Eight patients had leucopoenia (<$5.0{\times}10^9/L$), seven had thrombocytopenia (<$100{\times}10^9/L$), and three severe thrombocytopenia (<$50{\times}10^9/L$). Laparotomy was required in 10 of the 13 patients. Indications for operation in the acute phase were failure to respond to aggressive medical therapy in five, and perforation in three patients. There were two late phase operations for intestinal stricture and fistula. There were no operative complications. Ten of thirteen patients survived (76.9%). Two patients died of septic complication. There was a delayed death due to heart failure. There was a significant difference in survival according to platelet count ($50{\times}10^9/L$) (p<0.05). Congenital heart disease and Rota viral infection are associated with NEC in term infants and thrombocytopenia and leucopoenia may be surgical indications.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.81-85
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• 1985

Management of the small lower ureteral stone has been attempted by either transurethral manipulation or expectant therapy. To date, however, the choice of proper method has depended mostly on clinician's preference, and the effectiveness of the transurethral stone manipulation has remained controversial Herem we evaluated the effectiveness of the transurethral stone manipulation, using with the Dormia dislodger, in 37 patients with lower ureteral stone less than 10mm in greatest diameter. The results are summarized as follows. 1. The overall success rate was 68% (25 of 37 patients); Immediate delivery of the stone was observed in 16 of 37 patients. In another 5 patients the stone was removed at the time when the indwelled ureteral catheter was taken out. In the remaining 4 patients the stone passed spontaneously within a week following the procedure. 2. Higher success rate was observed in smaller stone; 79% in less than 4 mm, 58% in 4-6 mm, and 33% in 6-10mm in it's greatest diameter, respectively. 3. The morbidity rate was 8.1% (3 of 37 patients); In one patient a broken basket was retained In the ureter, which was removed at the time of ureterolithotomy. In another patient a ureteral stricture requiring periodic dilation was complicated. And In the other patient persistent hematuria was observed, which was relieved by conservative management. These results suggest that transurethral manipulation might have to be initially applied to unremittingly painful patients with small lower ureteral stone.

• Journal of Yeungnam Medical Science
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• v.7 no.2
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• pp.197-202
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• 1990

Mechanical obstruction of the common hepatic duct includes the following causes ; choledocholithiasis, sclerosis, cholangitis, pancreatic carcinoma, cholangiocarcinoma, postoperative stricture, primary hepatic duct carcinoma, enlarged cystic duct lymph nodes, and metastatic nodal involvement of the porta hepatis. Partial mechanical obstruction of the common hepatic duct caused by impaction of stones and inflammation surrounding the vicinity of the neck of the gallbladder had been reported on the "syndrome del conducto hepatico" in 1948 by Mirizzi. Nowadays, this disease was named by Mirizzi syndrome. Mirizzi syndrome is a rare entity of common hepatic duct obstruction that results from an inflammatory response secondary to a gallstone impacted in the cystic duct or neck of the gallbladder. It results from an almost parallel course and low insertion of the cystic duct into the common hepatic duct. In a varient of Mirizzi's syndrome, the cause of the common hepatic duct obstruction was a primary cystic duct carcinoma rather than gallstone disease. A 71-year-old man was admitted with a four-day history of right upper quadrant abdominal pain. Past medical history was unremarkable. On physical examination, the patient had a temperature of $38^{\circ}C$, icteric sclera and right upper quadrant tenderness. Pertinent laboratory findings included WBC 18,000/$cm^2$;albumin 2.6g/dl(normal 3.9-5.1) ; SGOT 183u/L(normal 0-50) ; SGPT167u/L(normal 0-65) ; bilirubin, 8.2mg/dl(normal 0-1) with the direct bilirubin, 4.4mg/dl(normal 0-0.4). Ultrasonography revealed a dilated extrahepatic biliary tree. ERCP showed that the superior margin was angular and more consistent with a calculus causing partial CHD obstruction(Mirizzi syndrome). At surgery a diseased gallbladder containing calculi was found. In addition, there was two calculi partially eroding through the proximal portion of the cystic duct and compressing the common hepatic duct. A cholecystectomy and excision of common bile duct was performed, with Roux-en-Y hepaticojejunostomy. The postoperative course was uneventful.

• Tuberculosis and Respiratory Diseases
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• v.52 no.1
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• pp.54-61
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• 2002

Background: Tracheal stenosis is an urgent but uncommon disease. Therefore, primary care clinicians have limited clinical experience. Animal models of a tracheal stenosis can be used conveniently for the learning, teaching, and developing new diagnostic and therapeutic modalities for tracheal stenosis. Recently, a canine model of a tracheal stenosis was developed using a Nd-YAG laser. To describe the methods and results of developed animal model, we performed this study. Methods : Six Mongrel dogs were generally anesthetized and the anterior 180 degree of tracheal cartilage of the animal was photo-coagulated using a Nd-YAG laser. The animals were bronchoscopically evaluated every week for 4 weeks and a pathologic evaluation was also made. Results : Two weeks after the laser coagulation, the trachea began to stenose and the stenosis progressed through 4 weeks. All animals suffered from shortness of breath, wheezing, and weight loss in the 3 weeks after the laser treatment, and two died of respiratory failure just before the fourth week. The gross pathologic findings showed the loss of cartilage and a dense fibrosis, which resulted in a fibrous stricture of the trachea. Microscopy also showed that the fibrous granulation tissue replaced destroyed cartilage. Conclusion : The canine model can assist in the understanding and development of new diagnostic and therapeutic modalities for tracheal stenosis.

• Journal of Gastric Cancer
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• v.3 no.2
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• pp.93-96
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• 2003

Purpose: Synthetic absorbable monofilaments offer excellent glide characteristics and cause minimal tissue trauma as a result of their smooth monofilament structure and gradual absorption within the healing tissues. For these reasons, these suture materials are commonly used in various surgical fields such as gastroenterology, urology, gynecology, and plastic surgery. The aim of this study was to evaluate the safety and usefulness of a new synthetic absorbable monofilament, Glycoside-..-caprolactone-trimethylene carbonate interpolymer (GCT), in gastrointestinal anastomosis and closure. Materials and Methods: We evaluated 55 gastrointestinal anastomoses and closures using GCT $MONOSYN^{R}$, B. Braun, Germany) in 47 patients who underwent gastric surgery between December 2001 and May 2002 at Seoul National University Hospital. Patient's characteristics, operative procedure, surgeon's opinion of handling properties of GCT, and suture-related complications were analyzed. Results: There were 34 males and 13 females (M:F= 2.6:1) with an average age of 54.2 years old. Forty-five cases of gastrointestinal anastomosis (20 gastrojejunostomies and 25 jejunojejunostomies) and 10 cases of intestinal closure (7 gastrostomy closures and 3 duodenal stump closures) were performed in 41 cases of stomach cancer, three of peptic ulcer disease, two of GIST, and one MALToma. The handling properties of GCT according to the criteria of knot breaking load, knot security, and placing property were always scored with 7 to 9 points (10=excellent, 1=very poor). Two cases of postoperative complications ($3.6\%$) were noted. One was a leak of the gastrojejunostomy site which was successfully managed conservatively, and the other was a stricture of the gastrojejunostomy site which was managed by reoperation (side-to-side jejunojejunostomy). Conclusion: GCT seems to be an applicable suture material for various gastrointestinal anastomoses and closures.

• Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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• v.8 no.2
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• pp.91-97
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• 2010

As nuclear power plants are getting older, interests on a decontaminating process are increasingly attracting more attention. Chemical decontamination is crucial to lower the production of radioactive waste and radiation dose rate. Prior to this, oxidizers and detergents for target material should be chosen so as to decontaminate major systems and components of a nuclear power plant chemically. In order to decontaminate it properly, it is crucial to have information about the chemical composition and crystalline structure of CRUD, analyzing its samples from the target or the decontamination system with components. However, there is no program which enables the extraction of samples directly from the object or the decontamination system with components carrying genuine radioactivity. Therefore, it is limited to samples from corrosion products carrying partial radioactivity as a resource. The composition of CRUD varies considerably depending on refueling cycle because it is closely related to the constituent of basic material. After settling a target, it is crucial to analyze and obtain analytical information about CRUD as a decontamination target. In this paper, various technologies for manufacturing simulated CRUD are introduced as alternatives to unattained samples. A metal oxide or metal hydroxide was used to synthesize simulated cruds having chemical compositions and crystalline stricture similar to the actual one by 12 different methods. CRUD 4(metal oxides in the autoclave vessel) and CRUD 10(metal oxides in a crucible after hydrazing pretreatment)were chosen as the best method for Type 1 and Type 2.respectively. As these CRUD can be synthesized easily without using any specialized equipment or reagents in a short time and in large quantities, they are expected to stimulate the development of decontaminating agents and processes.

• Journal of the Korean Society of Radiology
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• v.16 no.7
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• pp.919-925
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• 2022

This study is an image reconstruction method after cervical CT scan. According to the oblique coronal reconstruction angle, i would like to suggest the reconstruction angle that can best express neural foraminal bony stricture. The angle created by drawing a line passing through the center of the spinal cord in the midsagittal plane of the cervical spine and the uncovertebral joint was measured. A line passing through the center of the spinal cord was drawn from the neural foramen, and the angle formed with the midsagittal plane was measured and compared. At the C4-5 level, the average was 9.2°, at the C5-6 level, the average was 9.9°, and at the C6-7 level, the average was 8.4°, the neural foraminal angle was measured to be larger than the uncovertebral joint angle. There was a statistically significant difference in mean (p<0.01). Also, it was found that the angle increased toward the lower cervical vertebrae. The angle between the neural foramen of the lower cervical vertebrae (C5-6, C6-7) and the center of the spinal cord is between 55 and 60°. Here, if the oblique coronal image is reconstructed to be 90°, the degree of neural foramen stenosis can be observed well. Because it is an image reconstruction using a conventional CT scan image, it does not receive additional radiation exposure. It is of great significance in diagnosing cervical neural foramen bony stenosis.

• Advances in nano research
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• v.16 no.4
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• pp.325-340
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• 2024

There are several novel uses for dispersing many nanoparticles into a conventional fluid, including dynamic sealing, damping, heat dissipation, microfluidics, and more. Therefore, melting heat and mass transfer characteristics of a 3-D MHD Hybrid Nanofluid flow over a rotating disc with presenting dufour and soret effects are assessed numerically in this study. In this instance, we investigated both ferric sulfate and molybdenum disulfide as nanoparticles suspended within base fluid water. The governing partial differential equations are transformed into linked higher-order non-linear ordinary differential equations by the local similarity transformation. The collection of these deduced equations is then resolved using a Chebyshev spectral collocation-based algorithm built into the Mathematica software. To demonstrate how different instances of hybrid/ nanofluid are impacted by changes in temperature, velocity, and the distribution of nanoparticle concentration, examples of graphical and numerical data are given. For many values of the material parameters, the computational findings are shown. Simulations conducted for different physical parameters in the model show that adding hybrid nanoparticle to the fluid mixture increases heat transfer in comparison to simple nanofluids. It has been identified that hybrid nanoparticles, as opposed to single-type nanoparticles, need to be taken into consideration to create an effective thermal system. Furthermore, porosity lowers the velocities of simple and hybrid nanofluids in both cases. Additionally, results show that the drag force from skin friction causes the nanoparticle fluid to travel more slowly than the hybrid nanoparticle fluid. The findings also demonstrate that suction factors like magnetic and porosity parameters, as well as nanoparticles, raise the skin friction coefficient. Furthermore, It indicates that the outcomes from different flow scenarios correlate and are in strong agreement with the findings from the published literature. Bar chart depictions are altered by changes in flow rates. Moreover, the results confirm doctors' views to prescribe hybrid nanoparticle and particle nanoparticle contents for achalasia patients and also those who suffer from esophageal stricture and tumors. The results of this study can also be applied to the energy generated by the melting disc surface, which has a variety of industrial uses. These include, but are not limited to, the preparation of semiconductor materials, the solidification of magma, the melting of permafrost, and the refreezing of frozen land.

• Korean Journal of Radiology
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• v.24 no.4
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• pp.305-312
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• 2023

Objective: Chronic enteropathy associated with SLCO2A1 gene (CEAS) is a recently recognized disease. We aimed to evaluate the enterographic findings of CEAS. Materials and Methods: Altogether, 14 patients with CEAS were confirmed based on known SLCO2A1 mutations. They were registered in a multicenter Korean registry between July 2018 and July 2021. Nine of the patients (37.2 ± 13 years; all female) who underwent surgery-naïve-state computed tomography enterography (CTE) or magnetic resonance enterography (MRE) were identified. Two experienced radiologists reviewed 25 and 2 sets of CTE and MRE examinations, respectively, regarding the small bowel findings. Results: In initial evaluation, eight patients showed a total of 37 areas with mural abnormalities in the ileum on CTE, including 1-4 segments in six and > 10 segments in two patients. One patient showed unremarkable CTE. The involved segments were 10-85 mm (median, 20 mm) in length, 3-14 mm (median, 7 mm) in mural thickness, circumferential in 86.5% (32/37), and showed stratified enhancement in the enteric and portal phases in 91.9% (34/37) and 81.8% (9/11), respectively. Perienteric infiltration and prominent vasa recta were noted in 2.7% (1/37) and 13.5% (5/37), respectively. Bowel strictures were identified in six patients (66.7%), with a maximum upstream diameter of 31-48 mm. Two patients underwent surgery for strictures immediately after the initial enterography. Follow-up CTE and MRE in the remaining patients showed minimal-to-mild changes in the extent and thickness of the mural involvement for 17-138 months (median, 47.5 months) after initial enterography. Two patients required surgery for bowel stricture at 19 and 38 months of follow-up, respectively. Conclusion: CEAS of the small bowel typically manifested on enterography in varying numbers and lengths of abnormal ileal segments that showed circumferential mural thickening with layered enhancement without perienteric abnormalities. The lesions caused bowel strictures that required surgery in some patients.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.1
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• pp.76-83
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• 2022

Backgrounds/Aims: The aim of this study was to evaluate longitudinal changes of post-liver transplantation (LT) biliary anatomy and to assess the association of increased laboratory values after LT with the development of post-LT anastomotic biliary stricture (ABS). Methods: Adult deceased donor LT recipients from 2008 and 2019 were evaluated. ABS was defined after blinded review of endoscopic cholangiograms. Controls were patients who underwent LT for hepatocellular carcinoma who did not have any clinical or biochemical concerns for ABS. Results: Of 534 patients who underwent LT, 57 patients had ABS and 57 patients served as controls. On MRI, ABS patients had a narrower anastomosis (2.47 ± 1.32 mm vs. 3.38 ± 1.05 mm; p < 0.01) and wider bile duct at 1-cm proximal to the anastomosis (6.73 ± 2.45 mm vs. 5.66 ± 1.95 mm; p = 0.01) than controls. Association between labs at day 7 and ABS formation was as follows: aspartate aminotransferase hazard ratio (HR): 1.014; 95% confidence interval (CI): 1.008-1.020, p = 0.001; total bilirubin HR: 1.292, 95% CI: 1.100-1.517, p = 0.002; and conjugated bilirubin HR: 1.467, 95% CI: 1.216-1.768, p = 0.001. Corresponding analysis results for day 28 were alanine aminotransferase HR: 1.004, 95% CI: 1.002-1.006, p = 0.001; alkaline phosphatase HR: 1.005, 95% CI: 1.003-1.007, p = 0.001; total bilirubin HR: 1.233, 95% CI: 1.110-1.369, p = 0.001; and conjugated bilirubin HR: 1.272, 95% CI: 1.126-1.437, p = 0.001. Conclusions: Elevation of laboratory values early after LT is associated with ABS formation.