As a fundamental study to increase the reproductive efficiency in cattle, highly motile sperm were separated and collected from raw semen, extended semen and frozen semen by different methods using various concentrations of bovine serum albumin or Tyrode's solution. Various characteristics and light microscopic and electron-microscopic morphology of sperm separated by different methods were compared. The results obtained were as follows; 1. The sperm separated from raw semen using bovine serum albumin showed significantly high value in motility, motile sperm count, percent of normal sperm and progressive motility, as compared with control sperm and revealed the highest sperm recovery rate when separated with 6% bovine serum albumin. 2. The sperm motility, percent of normal sperm and progressive motility of the highly motile sperm frozen after being separated from raw semen with bovine serum albumin, showed significantly high value than those of a control sperm and especially found the highest value when separated with 20% bovine serum albumin. 3. Light-microscopic percent of abnormality was significantly low in the prefrozen and postfrozen highly motile sperm separated with bovine serum albumin, as compared with control sperm. 4. Electron-microscopic finding of the highly motile sperm separated with bovine serum albumin showed low percent of deformity in the dilatation and vesiculation of cell membrane, in dilatation and density loss of acrosome than in those of control sperm. 5. It was impossible to separate the highly motile sperm from frozen semen with bovine serum albumin, but it was possible with Tyrode's solution. 6. Recovery rate of highly motile sperm from raw semen extended semen and frozen semen was the highest when the sperm pellet stood in Tyrde's solution for 80 minutes. 7. The highly motile sperm separated from raw semen, extended semen and frozen semen with Tyrode's solution showed significantly high value in motility, progressive motility and percent of normal sperm, as compared with control sperm. 8. Highly motile sperm, when separated from raw semen, extended semen and frozen semen with Tyrode's solution, showed significantly low percent of microscopic abnormality as compared with control sperm.
Budd-Chiari syndrome is a state of hepatic failure caused by impairment of blood flow anywhere from the inferior vena cava to the right atrium. In this case, a 45 year old patient had undergone membranotomy and dilatation with autogenous pericardial graft due to obstruction of the inferior vena cava caused by a congenital membrane in 1987. Ten years after the operation, restenosis occurred. Although a noninvasive method with a Gianturco stent dilatation was performed, a satisfactory result was not obtained. A reoperation was performed. The stenotic segment of inferior vena cava was excised and after augmentation with a prepared pentagon shaped Gore-Tex artificial graft allowing passage of two fingers. The patient's postoperative course was uneventful without signs of rebleeding or any other complications and the patient was discharged at postoperative two weeks without the use of anticoagulants. An excellent result was obtainable after operation using a prepared Gore-Tex graft and such a result. Reoperational case of Budd-Chiari syndrome may require rapid and excellent the operative techenic by prevention of massive bleeding under use of extracorporeal circulation.
Park, Kwi-Won;Yang, Seok-Jin;Chun, Yong-Soon;Jung, Sung-Eun;Lee, Seong-Cheol;Kim, Woo-Ki
Advances in pediatric surgery
/
v.3
no.1
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pp.47-53
/
1997
Accidental ingestion of caustic substance is one of the common problems among children around the world. Acid intake accounts for a mere 5% of all reported cases of corrosive ingestion in the West. Because of the esophageal sparing effect of acid, clinically significant esophageal involvement after acid ingestion occurs in only 6 to 20 percent of the instances. Despite effort of prevention, 7% to 15% of children sustaining caustic esophageal burns develop esophageal strictures. If balloon dilatation or bougie dilatation fails to resolve the esophageal strictures, successful outcome following replacement by colon or stomach has been reported in children. But the complications and morbidity following these operations are still relatively high. Seven patients with corrosive-acid induced esophageal strictures who were operated upon at the Department of Pediatric Surgery, Seoul National University Children's Hospital from 1991 to 1995 were reviewed. Primary resection and anastomosis was performed in all of 7 patients. The stricture involved short segments of the esophagus at the level of the lower cervical and the upper thoracic vertebra. The operations were approached through a left cervical incision or a left thoracotomy. In one patient, operative repair of anastomotic leakage was done, and three patients required re-resection of anastomotic strictures postoperatively, and one patient required a third operation(reversed gastric tube) due to an anastomotic stricture. The other anastomotic leaks, strictures or pulmonary complications were resolved with conservative treatment. In conclusion, primary resection and anastomosis of the esophagus was performed successfully on the 6 of 7 children with acid induced corrosive esophageal strictures. This approach is physiologic, especially in children who should have a long life expectancy, and recommended for the treatment of short-segment acid induced corrosive esophageal strictures.
This study is to observe the effects of nursing care according to change of position for comfort during labor and safe delivery of newborn infants and perturbment women. Fifty antepartal primipara with labor pain who were admitted to the delivery room of H University Medical Center from September 1, 1976 to November 15, 1976 (Estimate Delivery Confinement) were selected for this investigation. Among the 50 parturiencys, the experimental group (28 primipara) were placed in 30 degree upright sitting position and the control group (22 primipara) were placed in the supine position. following placement, both groups were observed. The summarized findings of the study were as follows; 1. There was a noticeably significant difference in the duration of the first stage of labor (defined as 4 cm. dilatation of the cervical os with the fetal presenting part engaged to full or 10 cm. dilatation) , between the two groups. For women in the 30 degree upright sitting position, the first stage of labor was close to 33.66 minutes shorter. than for the women in the supine position. (t : 32.79, D.F : 48, p<0.0,i) 2. Although slight differences were observed between the Apgar Scores of the newborn infants of primipara in the two groups, these were not significant. The mean Apgar Score among the newborn infants of primipara in the 30 degree upright sitting position was 9.64 compared with 9.04 for the newborn infants of primipara in the supine position, a difference of 0.6. (x$^2$= 2.44, D.F : 2, p〉0.05) 3. There was a significant difference in the conformability of the perturbment women between the two groups because the shortened duration of the first stage and the high level of comfort score calculated for six factors (body activity, serving bed pan, serving kidney basin, pushing, deep breathing and perturbment women's feelings), that affect nursing care.
The purpose of this study is to analyse clinical impact of specific MRI findings in liver in patients of long-term survivors after Kasai portoenterostomy (KPE). Twenty-eight patients who were underwent KPE were followed up more than 5 years. Macro-regenerative nodule (MRN) and beaded-duct dilatation (BDD) were considered as important findings in liver MRI. The association between these findings in MRI and clinical indicator, serum bilirubin level and history of cholangitis were evaluated. Sixteen patients (57.1%) were shown MRN in liver MRI. Therewere 14 patients(50%) whose MRI showed BDD. Serum total and direct bilirubin were 3.6 mg/dL and 1.8 mg/dL respectively in positive MRN group whereas 1.4 mg/dL and 0.7 mg/dL in negative MRN group (p = 0.427). Serum total and direct bilirubin level were 4.2 mg/dL and 2.1 mg/dL in patients with BDD negative group compare to 1.1 mg/dL and 0.5 mg/dL in BDD positive group (p = 0.281). The odds ratio to have cholangitis in the patient with MRN was 2.3 and 0.53 in patient with BDD in their MRI findings. MRN in liver MRI may suggest high bilirubin level and more chance to have cholangitis, but the findings of BDD may related to low bilirubin level and less change to have cholangitis.
Objective: Computed tomography following myelography (CTM) revealed an unusual flow of contrast dye into the anterior median fissure (AMF) in a patient with cervical spondylotic myelopathy. Since then, several AMF configurations have been observed on CTM. Therefore, we evaluated morphological patterns of the AMF on CTM and investigated the significance and mechanisms of contrast dye flow into the AMF. Methods: Morphological patterns of the AMF on CTM were examined in 79 patients. Group A (24 patients) underwent surgery because of symptomatic cervical myelopathy. Group B (43 patients) had no clinical symptoms but showed spinal cord compression on CTM. Group C (12 patients), who showed neither clinical symptoms nor cord changes, underwent CTM for lumbar lesion evaluation. AMF patterns were classified into 4 types according to their configurations on CTM (reversed T, Y, V, and O types). Results: In group B, the reversed T type and Y type appeared significantly more often near the compressed portion (p<0.001). A similar tendency was seen in group A. The V and O types were most frequently observed in group C (p<0.001). Conclusion: On CTM, contrast dye tends to flow into the AMF of the cervical cord when the spinal cord is compressed. We speculate that there may be 3 possible mechanisms for this phenomenon: deformation of the epipial layer of the AMF due to cervical cord compression, AMF dilatation due to atrophy of the anterior funiculus or anterior horn, and temporary AMF dilatation when it becomes an alternative route for cerebrospinal fluid circulation.
Chun, Sangwook;Ryu, Jae-Wook;Ryu, Kyoung Min;Seo, Pil Won
Journal of Chest Surgery
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v.54
no.1
/
pp.31-35
/
2021
Background: Arteriovenous fistula (AVF) for hemodialysis is essential for patients with end-stage renal disease. However, it is difficult to maintain AVF reliably. It is vitally important to select proper blood vessels for AVF formation. In a previous study, a minimum diameter of 3 mm for the autologous vein was proposed. However, patients who did not meet the minimum vascular diameter before anesthesia, but fulfilled other criteria, showed satisfactory venous dilatation after brachial plexus block (BPB). This study investigated the extent of vein expansion by BPB and the surgical outcomes of dilated veins after BPB. Methods: Sixty-one patients who underwent AVF formation using an autologous vein between August 2018 and December 2019 were included in the study. The clinical characteristics of the patient groups, hemodynamic parameters including the diameter of blood vessels before and after BPB, and complications were investigated. Based on the venous diameter measured by sonography before anesthesia, patients were divided into group A (26 patients) and group B (35 patients), with venous diameters <3 mm and ≥3 mm, respectively. Results: The venous diameter expanded after anesthesia by 41% overall, by 62% in group A, and by 25% in group B. This difference between groups A and B was statistically significant (p=0.001). No other variables showed statistically significant differences. Conclusion: Sufficient venous dilatation was observed after BPB. Therefore, if the vein is sufficiently dilated after BPB, even in patients with a pre-anesthesia venous diameter <3 mm, surgery may still be performed with an expected desirable outcome.
Purpose: Although endoscopic retrograde cholangiopancreatography (ERCP) has been used for more than five decades, its applicability in Bangladeshi children has recently become more common. Therefore, this manuscript aims to describe our experience in performing ERCPs in Bangladeshi children with hepatopancreaticobiliary diseases, focusing on presenting diseases, as well as the diagnostic and therapeutic efficacy. Methods: Between 2018 and 2021, 20 children underwent 30 ERCP procedures at the Bangladesh Specialized Hospital, Dhaka. A single trained adult gastroenterologist performed all procedures using a therapeutic video duodenoscope. The indications for ERCP, diagnostic findings, therapeutic procedures, and complications were documented. Results: The median age of the study patients was 10 years (range, 1.7-15 years). Successful cannulation of the papilla was achieved in 28 procedures and failed in 2 cases. Repeated ERCP was required in seven patients. Nine patients had biliary indications and 11 had pancreatic indications. Choledocholithiasis was the most common indication for ERCP in patients with biliary disease, while chronic pancreatitis was common among patients with pancreatic indications. Pancreatic divisum was observed in only one patient. Pancreatic and biliary sphincterotomy was performed in 14 and 9 cases, respectively. A single pigtail or straight therapeutic stent was inserted in seven cases and removed in five cases. Stone extraction was performed in six procedures, and balloon dilatation was performed in five procedures. The post-procedural period for these patients was uneventful. Conclusion: We found that ERCP is a practical and successful therapeutic intervention for treating hepatopancreaticobiliary disorders in children when performed by experienced endoscopists.
A 3-year-old, 20.6 kg, neutered male German Shepherd dog was referred to Kyungpook National University Veterinary Medicine Teaching Hospital. Clinical examination revealed chronic diarrhea for 6 weeks and a non-tender, distended abdomen without lethargy, anorexia, and vomiting. Diarrhea was watery and had a waxing and waning course despite symptomatic treatment. A complete blood count identified mild leukocytosis and mild anemia. Serum biochemistry analysis showed elevated alanine aminotransferase and aspartate aminotransferase levels, and mild hypoalbuminemia. Abdominal ultrasound examination revealed mixed echogenicity with absent blood flow at the caudate process of the caudate liver lobe and a small amount of ascites. Computed tomography revealed torsion of the caudate process of the caudate liver lobe and spleen and gas dilatation of the intestine. After establishing a diagnosis of organ torsion on imaging, we deemed the condition an emergency and immediately performed surgery. Given that laparotomy confirmed organ torsion, liver lobectomy, total splenectomy, and prophylactic gastropexy were conducted. The patient was discharged 11 days after surgery without complications. In general, liver lobe torsion and splenic torsion are uncommon in dogs and present with nonspecific clinical signs, such as abdominal pain, lethargy, anorexia, and vomiting. In the current case, torsion of the caudate liver lobe and spleen occurred without other clinical signs except for a distended abdomen. Moreover, no reports in dogs have demonstrated the simultaneous occurrence of both diseases.
A broiler farm in Jeonbuk province experienced high mortality due to decreased feed intake and poor growth, and pathological evaluation of 11- and 17-day-old broilers was performed, which led to the diagnosis of runting-stunting syndrome. From the start of the rearing period to shipment, 18.4% of the chickens in the three barns experiencing continuous culling and mortality were affected, compared to 7.7% in the other five barns. Gross findings on the 11-day-old broiler chicken revealed proventricular dilatation and hemorrhage, intestinal hemorrhage, urate deposition in the pericardium and renal tubule, nephropathy, and mild hepatic capsulitis. Similar proventricular dilatation and hemorrhage were observed in the 17-day-old broiler chickens. In addition, hepatitis and pericarditis were observed with the progression of secondary bacterial infection, and pathogenic Escherichia coli was isolated from these lesions. As a result of PCR, Newcastle disease virus, fowl adenovirus, chicken anemia virus and Marek's disease virus were not detected in the all tissue samples. In contrast, infectious bronchitis virus was detected in the proventriculus, kidney and cecal tonsil. chicken astrovirus was detected in the intestine, cecal tonsil and bursa of Fabricius, and chicken parvovirus was detected in proventriculus, intestine, cecal tonsil and bursa of Fabricius. By sharing the diagnostic process of a case of malabsorption syndrome through this case report, we hope that it can be widely utilized in the diagnostic process of livestock disease pathognomonic institutions.
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