• 제목/요약/키워드: abdominal wall

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Interventional Approaches for Treatment of Saddle Embolus in Two Cats with Hypertrophic Cardiomyopathy (고양이 심근비대증에 병발한 안장색전증의 중재치료 증례)

  • Kang, Min-Hee;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.31 no.4
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    • pp.298-302
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    • 2014
  • An 8-year-old castrated male domestic shorthair cat (Case 1) and 3-year-old castrated male Siamese cat (Case 2) was presented with acute paresis of the hindlimbs, constant open-mouth breathing, and hemoptysis. Heart murmur (Case 1) and gallop sound (Case 2) was ausculated on the left heart base. Radiographs revealed alveolar infiltration of the caudodorsal lung lobes with aerophagea in Case 1 and prominent cardiomegaly in Case 2. Marked concentric hypertrophy of the ventricular septum and free wall, and left atrial enlargement was detected through echocardiography in both cats. Based on the examinations including echocardiography, those cats were diagnosed as hypertropic cardiomyopathy. Abdominal ultrasound revealed echogenic material in the aortic trifurcation region, aortic thromboembolism (ATE). Although prognosis of those animals was guarded, interventional therapeutic approach through direct endovascular thrombolytic therapy was attempted. ATE was visualized through angiography; however dissolving the embolus using interventional thrombolytic approach was not successful due to the extensive thrombus.

Anatomical Review of Rectus Abdominis Muscle Free Flap for the Oral and Maxillofacial Reconstruction (구강악안면재건을 위한 복직근 유리피판의 해부학적 고찰)

  • Park, Jung Min;Seo, Mi Hyun;Kim, Soung Min;Kang, Ji Young;Myoung, Hoon;Lee, Jong Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.5
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    • pp.367-375
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    • 2012
  • Midfacial reconstruction following resection of extensive malignant oral cavity tumors constitutes a challenging problems for reconstructive surgeons. Rectus abdominis muscle free flap (RAMFF) can be considered as the optimal reconstructive option in this case, because this flap has some advantages including consistent deep inferior epigastric artery anatomy, easy to dissect with well defined skin boundaries, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with oral cancer ablation surgery. The rectus abdominis muscle forms an important part of the anterior abdominal wall and flexes the vertebral column, which is a long strap-like muscle divided transversely by three tendinous intersections, fibrous bands which are adherent to the anterior rectus sheath, which is thickly enclosed by the rectus sheath, except for the posterior part below the arcuate line that is usually located midway between the umbilicus and symphysis pubis. Below the arcuate line, this muscle lies in direct contact with the transversalis fascia and parietal peritoneum. For the better understanding of RAMFF as a routine reconstructive procedure in oral and maxillofacial surgery, the constant anatomical findings muse be learned and memorized by the young doctors in the course of the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article will discuss the anatomical basis of RAMFF with Korean language.

Spontaneous Perforation of the Bile Duct (담관의 자연 천공)

  • Yoo, Soo-Young;Park, Yong-Tae;Choi, Seung-Hoon;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.2 no.2
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    • pp.143-147
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    • 1996
  • Spontaneous perforation of the bile duct in children is a very rare disorder. We experienced a 6 year-old girl with spontaneous perforation of the right hepatic duct. The patient was initially misdiagnosed as hepatitis because of elevation of liver enzyme and then as appendicitis because of fluid collection in the pelvic cavity demonstrated by ultrasonogram. A laparoscopic exploration was done and no abnormal findings were detected except bile-stained ascites. Peritoneal drainage was performed and the patients seemed to improve clinically. Abdominal pain, distention and high fever developed after removal of the drains. DISIDA scan showed a possible of bile leak into the peritoneal cavity. ERCP demonstrated free spill of dye from the right hepatic duct. At laparotomy, the leak was seen in the anterior wall of the right hepatic duct 2cm above the junction of the cystic duct and common hepatic duct. The perforation was linear in shape and 0.8cm in size. The patient underwent cholecystectomy, primary closure of the perforation and T-tube choedochostomy. We could not identify the cause of the perforation; however, the T-tube cholangiography taken on the 42nd postoperative day showed a little more dilatation of the proximal common bile duct compared with the cholangiography taken on the 14th day. Long-term follow-up of the patient will be necessary because of the possibility for further change of the duct.

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Malignant Extrarenal Rhabdoid Tumor in Soft Tissue - A Case Report - (연부 조직에 발생한 악성 횡문근양 종양 - 증례 보고 -)

  • Lee, Sang-Hoon;Kim, Han-Soo;Oh, Joo-Han;Suh, Sung-Wook;Lee, Han-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.4
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    • pp.173-177
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    • 2000
  • Malignant rhabdoid tumor is a highly aggressive tumor of children, that often arises in the kidney. Some rhabdoid tumors have been reported in various extra-renal location including the central nervous system, liver, skin, and soft tissues. In case of arising in soft tissues, it may be misdiagnosed as rhabdomyosarcoma. It is important to distinguish malignant rabdoid tumor from rhadomyosarcoma, because malignant rhabdoid tumor has more aggressive behavior and poorer survival rate. And this differential diagnosis can be performed by several immunohistochemistry. Here we report a case of malignant rhabdoid tumor that arose in lower abdominal wall with related articles.

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Clinical Characteristics and Ultrasonographic Findings of Acute Bacterial Enterocolitis in Children

  • Chun, Peter;Lim, Taek Jin;Hwang, Eun Ha;Mun, Sang Wook;Lee, Yeoun Joo;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.2
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    • pp.107-113
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    • 2017
  • Purpose: This study clarified the bacterial pathogens currently causing acute infectious enterocolitis (AIE) in children and evaluated the clinical characteristics and ultrasonographic findings according to the different pathogens. Methods: Medical records regarding age, sex, clinical symptoms, laboratory data, identified enteropathogens, ultrasonographic findings, treatment, and outcome of 34 patients who were diagnosed with AIE via stool examination using multiplex polymerase chain reaction (PCR) or culture, were retrospectively reviewed. Results: Twenty-four patients (70.6%) were male. The mean age of the patients was $8.5{\pm}6.2$ (range, 1.1-17.1) years. Six bacterial pathogens were isolated: Salmonella species (spp.) (32.4%), Campylobacter spp. (20.6%), verotoxin-producing Escherichia coli (14.7%), Staphylococcus aureus (11.8%), Clostridium difficile (8.8%), and Shigella spp. (2.9%). Abdominal pain occurred in all patients regardless of pathogen. The patients infected with Salmonella were older than those infected with verotoxin-producing E. coli (p<0.05). C-reactive protein levels were higher in patients with Salmonella and Campylobacter infections than in those with verotoxin-producing E. coli infection (p< 0.05), the other clinical and laboratory data were indistinguishable between pathogens. Ultrasonography demonstrated diverse involvement of bowel segments according to pathogen. Wall thickening of both the ileum and the entire colon was the most common lesion site regardless of pathogen. Conclusion: Various bacterial agents cause AIE and the symptoms are diverse symptoms, however, all most children recovered spontaneously. Use of multiplex PCR on stool samples warrants improvement of its sensitivity for diagnosis of enteropathogenic bacteria. Ultrasonographic examination is useful for diagnosis of AIE; it can also detect the disease extent and severity.

Three Cases of Extrahepatic Bile Duct Disorder: Diagnostic Imaging in Perspective (진단 영상을 위주로한 간외 담도계 질환 3례)

  • Lim Chang-yun;Jeong Yu-cheol;Oh Sun-kyoung;Jung Joo-hyun;Kim So-hee;Kim Nam-hyang;Seo Kyeong-won;Hwang Cheol-yong;Byeon Ye-eun;Kweon Oh-kyeong;Choi Min-cheol;Yoon Junghee
    • Journal of Veterinary Clinics
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    • v.22 no.4
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    • pp.412-416
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    • 2005
  • Three cases of extrahepatic bile duct disorder were presented. Two cases, a dog and a cat, were related to the obstruction of the extrhepatic bile duct, the other dog was affected with the gall bladder rupture. The clinical signs included anorexia, abdominal distension and vomiting. The laboratory test represented increased hepatic enzymes. On the radiography, hepatomegaly was seen in the obstructive cases, and ascites could be seen in the ruptured case. On the Ultrasonography, dilated gall bladder and extrahepatic bile duct were found in the obstructive cases, and there were ascites, indistinct gall bladder wall, dilation of gall bladder and extrabiliary tract, increased mesenteric echogenicity in the ruptured case. All presented were taken medication, surgical foreign material removal, or cholecystectomy showed complete recovery.

Ultrasonographic Appearance of Liver and Duodenum in Relation to Growth in Native Korean Cattle (한우에서 성장에 따른 간장 및 십이지장의 초음파상)

  • 김명철;변홍섭;신상태;황광남;박명호;이경광;한용만;박경수
    • Journal of Veterinary Clinics
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    • v.14 no.1
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    • pp.11-18
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    • 1997
  • This study was performed to make fundamental data of ultrasonographic diagnosis for liver and duodenum disease in native Korean cattle. Ultrasonographic appearance of liver, caudal vena cava, portal vein, gall bladdr and duodenum according to the growth were determined from 6 to 13 months by monthly examinations in 9 native Korean cattle. The caudal vena cava was determined at 11th intercostal space by use of ultrasonography. The portal vein and gallbladder were determined at 10th intercostal space by use oof ultrasonography. The liver were determined at 12, 11 and 10 th intercostal space by use of ultrasonography. The liver, caudal vena cava, portal cein, gallbladder and duodenum were examinde in standing position. Ultrasonograms were obtainde with 3.5 or 5.0-MHz convex and 5.0-MHz sector transducer. The diameter of vena cava at the 6, 7, 8, 9, 10, 11, 12 and 13 months old age were 18.4, 20.6, 22.4, 25.1, 26.9, 27.3, 28.5 and 29.4 mm, respectively. The diameter of portal vein at the 6, 7, 8, 9, 10, 11, 12 and 13 months old age were 19.5, 20.6, 22.3, 24.5, 26.9, 28.1, 30.7 and 31.5 mm, respectively. The diameter of gall bladder at the 6, 7, 8, 9, 10, 11, 12 and 13 months old age were 63.2, 72.2, 75.1, 78.6, 80.5, 82.3, 84.4 and 91.1 mm, respectively. Cranial part of duodenum was identified near gall bladder by moving of hyperechoic ingesta. Descending duodenum paralleled with vertebrae is seen in the right upper flank and was adjacent to the abdominal wall, and was enveloped in the hyperechoic greater omentum, differentiating it from the jejunum and ileum. The diameter of cranial duodenum at the 6, 7, 8, 9, 10, 11, 12 and 13 months old age were 23.3, 27.9, 29.9, 32.2, 34.4, 34.5, 35.1 and 36.5 mm, respectively. The diameter of descending duodenum revealed smaller diameter than that of cranial duodenum. Calculi in gallbladder were observed by ultrasonography.

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Subxiphoid Incisional Hernia Development after Coronary Artery Bypass Grafting

  • Kim, Hye-Seon;Kim, Ki-Bong;Hwang, Ho-Young;Chang, Hyung-Woo;Park, Kyu-Joo
    • Journal of Chest Surgery
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    • v.45 no.3
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    • pp.161-165
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    • 2012
  • Background: Median sternotomy can weaken the upper abdominal wall and result in subxiphoid incisional hernia. We evaluated risk factors associated with the development of subxiphoid incisional hernias after coronary artery bypass grafting (CABG). Materials and Methods: Of 1,656 isolated CABGs performed between January 2001 and July 2010, 1,599 patients who were completely followed up were analyzed. The mean follow-up duration was $49.5{\pm}34.3$ months. Subxiphoid incisional hernia requiring surgical repair developed in 13 patients (0.8%). The hernia was diagnosed $16.3{\pm}10.3$ months postoperatively, and hernia repair was performed $25.0{\pm}26.1$ months after the initial operation. Risk factors associated with the development of subxiphoid incisional hernia were analyzed with the Cox proportional hazard model. Results: Five-year freedom from the hernia was 99.0%. Univariate analysis revealed that female sex (p=0.019), height (p=0.019), body surface area (p=0.046), redo operation (p=0.012), off-pump CABG (p=0.049), a postoperative wound problem (p=0.041), postoperative bleeding (p=0.046), and low cardiac output syndrome (p<0.001) were risk factors for the development of the hernia. Multivariable analysis showed that female sex (p=0.01) and low cardiac output syndrome (p<0.001) were associated with subxiphoid hernia formation. Conclusion: Female sex and postoperative low cardiac output syndrome were risk factors of subxiphoid hernia. Therefore, special attention is needed for patients with high-risk factors.

Management of Empyema Caused by a Gastropleural Fistula - A case report - (위늑막루에 의한 농흉의 치험 - 1예 보고 -)

  • Lee, Seong-Kwang;Lee, Yang-Haeng;Jeon, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Park, Kyung-Taek;Choi, Chang-Soo
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.340-343
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    • 2010
  • Gastropleural fistula is a rare complication of prior lung surgery, gastric ulcer, trauma and malignancy. A 62 year old female patient who had received surgical repair of a perforated gastric wall 10 years prior, underwent open pleural decortication. At 4 days after surgery, food residuums were noticed at the chest bottles. Hence, an emergency esophagogram was done. The esophagogram revealed a gastropleural fistula. The patient received a total gastrectomy, intra-abdominal diaphragmatic repair and massive thoracic saline irrigation through a previous thoracic wound. The patient was discharged 11 days after surgery without other morbidity.

Infection Route of Scuticociliates in the Juvenile of the Cultured Flounder, Paralichthys olivaceus (양식넙치, Paralichthys olivaceus 치어의 스쿠티카충 감염경로)

  • Jin, Chang-Nam;Lee, Chang-Hun;O, Sang-Pil;Na, O-Su;Heo, Mun-Su
    • Journal of fish pathology
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    • v.16 no.1
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    • pp.13-21
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    • 2003
  • The infection characteristics with scuticociliates at on-land rearing farms and hatcheries of flounder, Paralithys olivaceus was investigated during the year of 2001 by juvenile infection routes. When culture tanks for living food organisms such as chlorella, rotifer, and Artemia were searched, scuticocilates were detected both in live and dead rotifer, and at the dregs of culture tank bottoms at almost hatcheries. When rotifer infected with scuticocilates fed on fish larvae, lots of scuticocilate were inhabited at the bottom of fry rearing tanks. After feeding on scuticocilates-infected rotifer on fish larvae, first infection was detected at 10 days after bottom dwelling or 40 days old after hatching. By histopathological examination we confirmed the infection route of eyeball or brain contamination was that the ciliate worms digged through mouth and front part of the dosal fin cuticle, transferred into eyeball along the epithelium and muscle tissue, and reached finally into brain by the muscle and nerve tissue. The infection of internal organs was clarified into two routes. The first route was started from the infection at ventral and anal fin rays by the worms, and reached at the anus and rectum through the epithelium and muscle tissue. The second route was initiated from the infection at urinary organ and reached into the rectum epithelium cells, inner wall of intestine, abdominal cavity, pancreas, kidney, and pancreas. At seed production farms where fish larvae fed on scuticocilate-free rotifer, the worms were not detected not only at the food organisms culture tanks and juvenile rearing tanks but also larval flounder less than 7cm in total length.