• Clinical and Experimental Reproductive Medicine
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• 제29권4호
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• pp.245-250
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• 2002

Objective: To evaluate the efficacy of sclerotherapy for conservative treatment of ovarian pseudocyst. Methods: Patients with ovarian pseudocyst who had undergone sclerotherapy at Ajou University Hospital from February, 1997 to March, 2002 were included in this study. Sclerotherapy was performed as follows: Under intravenous analgesia, the cyst was irrigated with dehydrated alcohol after aspiration under transvaginal sonography. The aspirated contents and alcohol irrigated contents were sent for cytologic examination. Results: 71 patients with ovarian pseudocyst were performed sclerotherapy. All but 2 patients were followed up for 0.5 to 33 months with transvaginal sonography and pelvic examination. Mean age of the patients was 40 years old. Mean size of the pseudocyst was 8.0 cm, mean amount of aspiration fluid was 179.8 ml, and average follow-up duration was 6.0 months. All had abdominal or pelvic surgical history and 38 patients (58.9%) of them had undergone hysterectomy. 44 of 71 patients (62.0%) were performed sclerotherapy only one time. 27 patients (38.0%) recurred and were undergone more than one time. Complication was not occurred in all cases. Conclusions: We concluded that although pseudocyst after sclerotherapy has high recurrence rate, sclerotherapy was an safe and effective method for conservative treatment of ovarian pseudocyst.

• Journal of Trauma and Injury
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• 제22권1호
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• pp.57-64
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• 2009

Purpose: Computed tomography (CT) is an accurate test for evaluating hemodynamically stable patients with blunt abdominal trauma. Until now, there have been few studies concentrating on the diagnostic and prognostic significance of the intravenous contrast extravasation (CE) site. We investigated the site of CE on abdominopelvic CT (APCT) and its effect on treating trauma patients and predicting the clinical outcome. Methods: The 50 patients admitted to our emergency department with blunt abdominal trauma showing CE on APCT from January 2004 to September 2006 were included in this study. Patients were prospectively collected, and medical records were reviewed and analyzed. The patients'clinical and lab findings, Focused Assessment with Sonography for Trauma (FAST) findings, CT findings were analyzed. CE sites were classified as intraperitoneal, retroperitoneal, and pelvic cavity and were correlated with post-treatment complications, mortality, and morbidity. Results: Of the 50 patients (mean age : $45{\pm}18years$, 29 males, 21 females) included in our study, 33 patients died (66%). There was no correlation between CE site and ICU or total hospitalization duration (p=0.553, p=0.523). During the first 24 hours of resuscitation, the pelvic cavity group required a mean of 20 units more of packed red blood cell (pRBC) transfusion compared to other groups (p=0.003). In the intraperitoneal group, more patients received operative invasive intervention - either laparotomy or embolization (p=0.025). The intraperitoneal group had the highest mortality, with 13 deaths (11/33, 39%), and the highest early mortality rate (10/13, 76%) in the first 24 hours (p=0.001). Conclusion: Intraperitoneal CE on the CT scan in cases of blunt abdominal trauma is regarded as an indication of a need for invasive intervention (either angiography or laparotomy) and of a higher mortality rate in the first 24 hours. A pelvic cavity CE rquires more aggressive transfusion with pRBC. However, the CT findings themselves showed no significant correlation with overall mortality, morbidity, or hospitalization.

• The Korean Journal of Pain
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• 제26권4호
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• pp.374-378
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• 2013

Background: Incisional pain is particularly troublesome after hysterectomy. A method called transversus abdominis plane block (TAPB) has shown promise in managing postoperative pain. In this study, we evaluated the analgesic efficacy of ultrasound-guided TAPB after hysterectomy at different time points and at each time point separately for 48 hours. Methods: Forty-two patients (ASA I, II) who were electively chosen to undergo total abdominal hysterectomy were divided into 2 groups, control (group C) and intervention (group I). Twenty-one patients underwent TAPB (group I) and 21 patients received only the standard treatment with a fentanyl pump (group C). Both groups received standard general anesthesia. For patients in group I, following the surgery and before emergence from anesthesia, 0.5 mg/kg of ropivacaine 0.2% (about 20 cc) was injected bilaterally between the internal oblique and transverse abdominis muscles using sonography. Pain scores using the Visual Analogue Scale (VAS) and drug consumption were measured at 2, 6, 12, 24, and 48 hours after TAPB. Results: There were no significant differences in demographics between the two groups. VAS scores appeared to be lower in group I, although there was no interaction with time when we compared mean VAS measurements at different time points between group I and group C (P > 0.05). The amount of fentanyl flow was consistently higher in group C, but when we compared the two groups at each time point separately, the observed difference was not statistically significant (P < 0.053). The incidence of vomiting was 10% in group I and 28% in group C. There were no complaints of itching, and sedation score was 0 to 3. There were no complications. Conclusions: This study showed that TAPB did not result in a statistically significant decrease in VAS scores at different time points. TAPB did lead to decreased fentanyl flow, but when we compared the two groups at each time point separately, the observed difference was not statistically significant.

• Clinical and Experimental Pediatrics
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• 제54권5호
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• pp.219-223
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• 2011

McKusick-Kaufman syndrome (MKS) is an autosomal recessive multiple malformation syndrome characterized by hydrometrocolpos (HMC) and postaxial polydactyly (PAP). We report a case of a female child with MKS who was transferred to the neonatal intensive care unit of Seoul National University Children's Hospital on her 15th day of life for further evaluation and management of an abdominal cystic mass. She underwent abdominal sonography, magnetic resonance imaging, genitography and cystoscopy which confirmed HMC with a transverse vaginal septum. X-rays of the hand and foot showed bony fusion of the left third and fourth metacarpal bones, right fourth dysplastic metacarpal bone and phalanx, right PAP and hypoplastic left foot with left fourth and fifth dysplastic metatarsal bones. In addition, she had soft palate cleft, mild hydronephroses of both kidneys, hypoplastic right kidney with ectopic location and mild rotation, uterine didelphys with transverse vaginal septum and low-type imperforated anus. She was temporarily treated with ultrasound-guided transurethral aspiration of the HMC. Our patient with HMC and PAP was diagnosed with MKS because she has two typical abnormality of MKS and she has no definite complications of retinal disease, learning disability, obesity and renal failure that develop in Bardet-Biedl syndrome, but not in MKS until 33 months of age. Here, we describe a case of a Korean patient with MKS.

• Journal of Chest Surgery
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• 제35권3호
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• pp.239-243
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• 2002

본 증례의 39세 남자는 전신부종과 간부전증을 일으키는 Budd-Chiari syndrome과 상대정맥 폐색증을 가지고 입원하였다. 보존적 내과 치료 후 방사선과의 침습적 방법에 의한 확장술에 실패하여 하공정맥-우심방 단락술을 시행하였다. 수술은 정중흉골 절제술 및 직사행 복부 절제술을 통하여 직경 24 mm의 Dacron graft를 사용하여 좌신정맥 하에서 하공정맥-우심방 단락술을 체외순환을 하지 않고 시행하였다 수술후 출혈이나 합병증없이 양호한 결과를 보였으며 수술당일부터 항응고제 치료를 병행하였다. 술후 26일째 시행한 복부 도플러 초음파 상에서 graft의 유통성이 양호함을 확인하였다. 퇴원시 상대정맥 폐색 증상은 남아 있었으나 외래 추적 검사시 상대정맥 폐색 증상도 호전되었음을 확인할 수 있었다

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제4권1호
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• pp.104-107
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• 2001

저자들은 5개월 된 남아에게 장중첩증 원인으로 흔하지 않은 게실로 판명되었던 1례를 치험하여 문헌 고찰과 함께 보고하는 바이다.

• 한국임상수의학회지
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• 제28권5호
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• pp.542-545
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• 2011

질내 비정상적인 신생물과 질출혈 증상을 가진 12살의 암컷 오크셔테리어가 동물병원에 내원하였다. 복부초음파와 방사선 검사를 통하여 자궁의 비정상적인 비후가 인지되었다. 질 신생물 적출 수술과 난소자궁적출 수술이 수행되었다. 질 신생물은 육안적으로 단단하였고 난소와 자궁 주위에 다발성의 낭포가 관찰되었다. 조직학적으로 질 신 생물은 섬유종으로 진단되었고, 난소와 자궁의 신생물은 다발성 낭포를 동반한 선암종으로 진단되었다. 본 증례는 매우 드물게 암컷 개의 생식기에 서로 다른 종류의 종양이 동시에 발생한 다발성 복합 종양 발생례로서 생식기 종양의 이해 증진에 기여할 수 있는 자료를 제공할 수 있을 것으로 기대된다.

• Journal of Trauma and Injury
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• 제35권4호
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• pp.291-296
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• 2022

The therapeutic approach for colon injury has changed continuously with the evolution of management strategies for trauma patients. In general, immediate laparotomy can be considered in hemodynamically unstable patients with positive findings on extended focused assessment with sonography for trauma. However, in the case of hemodynamically stable patients, an additional evaluation like computed tomography (CT) is required. Surgical treatment is often required if prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation are observed. However, immediate intervention in hemodynamically stable patients without indications for surgical treatment remains questionable. Three patients with colon and mesocolon injuries caused by blunt trauma were treated by nonoperative management. At the time of admission, they were alert and their vital signs were stable. Colon and mesocolon injuries, large hematoma, colon wall edema, and/or ischemia were revealed on CT. However, no prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation were observed. In two cases, conservative treatment was performed without worsening abdominal pain or laboratory tests. Follow-up CT showed improvement without additional treatment. In the third case, follow-up CT and percutaneous drainage were performed in considering the persistent left abdominal discomfort, fever, and elevated inflammatory markers of the patient. After that, outpatient CT showed improvement of the hematoma. In conclusion, nonoperative management can be considered as a therapeutic option for mesocolon and colon injuries caused by blunt trauma of selected cases, despite the presence of large hematoma and ischemia, if there are no clear indications for immediate intervention.

• Clinical and Experimental Pediatrics
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• 제48권4호
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• pp.448-452
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• 2005

본 저자들은 전형적인 신경섬유종증 환자에서 이소성 신장을 동반한 환자를 최초로 경험하였기에 문헌고찰과 함께 보고한다.

• Childhood Kidney Diseases
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• 제19권2호
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• pp.167-170
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• 2015

Hypereosinophilic syndrome (HES) is characterized by the presense of hypereosinophilia with evidence of target organ damage. We report a patient diagnosed with eosinophilic cystitis and HES. A 7 year old boy had hematuria, dysuria, and increased urinary frequency for 1 day. Laboratory examinations revealed hypereosinophilia (eosinophils, $2,058/{\mu}L$), hematuria, and proteinuria. Abdominal sonography revealed diffuse and severe wall thickening of the bladder. The patient was treated initially with antibiotics. However, his symptoms did not improve after 7 days. A computed tomography scan demonstrated severe wall thickening of the bladder and the hypereosinophilia persisted (eosinophils, $2,985/{\mu}L$). The patient complained of chest discomfort, dyspnea, epigastric pain, and vomiting on hospital day 10. Parasitic, allergic, malignancy, rheumatologic, and immune workups revealed no abnormal findings. Chest X-rays, electrocardiography, and a pulmonary function test were normal; however, the hypereosinophilia was aggravated (eosinophils, $3,934/{\mu}L$). Oral deflazacort was administered. A cystoscopic biopsy showed chronic inflammation with eosinophilic infiltration. The patient's respiratory, gastrointestinal, and urinary symptoms improved after 6 days of steroids, and he was discharged. The eosinophil count decreased dramatically ($182/{\mu}L$). The hypereosinophilia waxed and waned for 7 months, and the oral steroids were tapered and stopped. This case describes a patient diagnosed with eosinophilic cystitis and HES.