• Clinical and Experimental Pediatrics
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• 제48권10호
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• pp.1082-1089
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• 2005

목 적 : 복부 비만은 고혈압, 인슐린 저항, 고인슐린혈증, 당뇨, 고지혈증과 같은 많은 심혈관계 질환의 위험 요인으로 제시되고 있다. 복부 비만을 측정하는 지표로 허리/둔부 비와 허리둘레가 사용되고 있으나, 관상동맥 질환의 예측인자로 복부 비만의 측정학적 cut-off 수치가 소아에서는 아직 제시되지 못하고 있다. 복부 전산화 단층촬영과 초음파를 이용하여 복부 지방을 측정하고, 여러 비만 지표들과의 상관관계를 연구함으로써 복부 비만의 합병증으로 초래되는 심혈관계 질환의 위험인자 평가 방법을 알아 보고자 본 연구를 실시하였다. 방 법 : 비만한 청소년 27명과 나이와 성별이 대등한 정상 체중을 가진 청소년 22명을 대상으로 하여 체질량 지수와 비만 지수, 상완둘레 및 삼각근에서 피부 두께를 비교하였다. 또한, 12시간 공복 상태에서 혈중 지질 및 혈당, 인슐린, 4가지 사이토카인을 측정하고, 인슐린 저항 지수를 구하였으며, 생체 전기저항법을 이용하여 체지방량, 체지방률, 복부지방률을 측정하여 비교하였다. 비만군에서는 복부 초음파로 배꼽부위 피하지방 두께와 복강 내 지방 두께를 측정하고, 복부 전산화 단층 촬영으로 얻은 횡단면 스캔에서 전체 지방 면적을 구하였고, 이 중 피하지방의 면적을 감산하여 복강 내 지방 면적을 구하였다. 결 과 : 소아에서 복부 CT로 측정한 총 지방 면적과 생체 전기 저항법으로 측정한 총지방량과 상관성이 매우 높았다(r=0.954, P<0.05). 복부 CT에서 측정한 복강 내 지방 면적은 상완둘레, 복부비만율, 초음파로 측정한 복부 내 지방 깊이 및 피하 지방량, 체질량 지수, 중성지방 등과 상관성이 높았다. 결 론 : 복부 CT는 복강 내 지방을 측정하는 가장 정확한 방법이지만 임상적으로 유용하지 못하므로, CT와 상관성이 높은 복부 초음파로 대치할 수 있다. 외래나 학교 신체검사에서 사용할 수 있는 선별 검사로는 생체 전기 저항법에 의한 체지방 측정, 상완 둘레, 체질량 지수, 허리/둔부 비 등이 있다. 소아 성인병의 심혈관 위험 예측 지표로는 공복시 leptin, 중성지방, 인슐린 농도 등을 사용할 수 있다.

• Journal of Preventive Medicine and Public Health
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• 제45권5호
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• pp.316-322
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• 2012

Objectives: Abdominal obesity increases mortality and morbidity from cardiovascular disease and there is a possibility that smoking effects obesity. However, previous studies concerning the effects of smoking on obesity are inconsistent. The objective of this study was to examine whether smoking is positively related to abdominal obesity in men with type 2 diabetes. Methods: Subjects consisted of 2197 type 2 diabetic patients who visited Huh's Diabetes Center from 2003 to 2009. Indices of abdominal obesity were defined as visceral fat thickness (VFT) measured by ultrasonography and waist circumference (WC). Overall obesity was defined as body mass index (BMI). Results: Statistically significant differences in WC and VFT by smoking status were identified. However, there was no statistical difference in BMI according to smoking status. Means of WC and VFT were not significantly higher in heavy smokers and lower in mild smokers. Compared to nonsmokers, the BMI confounder adjusted odds ratio and 95% confidence interval for VFT in ex-smokers and current-smokers were 1.70 (1.21 to 2.39) and 1.86 (1.27 to 2.73), respectively. Conclusions: Smoking status was positively associated with abdominal obesity in type 2 diabetic patients.

• Journal of Korean Neurosurgical Society
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• 제51권2호
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• pp.81-85
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• 2012

Objective : The purpose of this prospective study was to evaluate the effects of body mass index (BMI) on intra-abdominal pressure (IAP) and intraoperative blood loss (IBL) during lumbar spinal surgery. Methods : Thirty patients scheduled for single level posterior lumbar interbody fusion were allocated equally to a normal group (Group 1, BMI;$18.5-22.9kg/m^2$), an overweight group (Group 2, BMI; $23-24.9kg/m^2$), and an obese group (Group 3, BMI; $25.0-29.9kg/m^2$) according to BMI. IAP was measured using a urinary bladder catheter; 1) supine after anesthesia induction, 2) prone at skin incision, 3) prone at the end of surgery. In addition, IBL was also measured in the three groups. Results : IAP in the supine position was not significantly different in groups 1, 2, and 3 (2.7 mm Hg, 3.0 mm Hg, and 4.2 mm Hg, respectively) ($p$=0.258), and IAP in the prone position at incision increased to 7.8 mm Hg, 8.2 mm Hg, and 10.4 mm Hg, respectively, in the three groups, and these intergroup differences were significant, especially for Group 3 ($p$=0.000). IAP at the end of surgery was slightly lower (7.0 mm Hg, 7.7 mm Hg, and 9.2 mm Hg, respectively). IBLs were not significantly different between the three groups. However, IBLs were found to increase with IAP in the prone position ($p$=0.022) and BMI ($p$<0.05). Conclusion : These results show that BMI affects IAP in the prone position more than in the supine position during lumbar spinal surgery. In addition, IBLs were found to increase with IAP in the prone position and with BMI. Thus, IBLs can be expected to be higher in morbidly obese patients due to an increased IAP.

• Advances in pediatric surgery
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• 제2권2호
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• pp.138-142
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• 1996

Pulmonary sequestration is a complex anomaly involving the pulmonary parenchymal tissue and its vasculature. It presents as a cystic mass of nonfunctional lung tissue without communication with the tracheobronchial system. Usually, it receives blood supply from anomalous systemic vessels. Therefore, preoperative diagnosis of the pulmonary sequestration is difficult, especially when it is located in the abdomen and combined with congenital cystic adenomatoid malformation(CCAM). We encountered such a mass(CCAM type 2) detected prenatally by ultrasonography. It was a kidney bean shaped, pinkish mass straddling the thorax and abdomen on the right side. Because of the sonographic appearance, neuroblastoma was diagnosed preoperatively. The mass was completely extirpated without difficulty.

• Advances in pediatric surgery
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• 제8권2호
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• pp.138-142
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• 2002

Mesenteric and omental cysts are rare intra-abdominal lesions in childhood, and may present various clinical features such as an asymptomatic mass or an acute abdomen. Therefore, these entities are frequently misdiagnosed preoperatively or are found only incidentally at operation for other conditions. We analyzed our experiences of 19 cases in a 19 year period from 1981 to 1999, at College of Medicine, Catholic University of Korea. There were 12 boys and 7 girls with a mean age of 4.8 years (range, 3 days to 15 years). Common presenting symptoms were abdominal pain (47%), abdominal distension (31%), abdominal mass (24%), vomiting (15%) and fever (10%). Ultrasonography was the most preferred method of diagnosis. Other diagnostic modalities include CT, MRI, and abdominal ascites tapping in selected patients. Location of the mesenteric cysts was small bowel mesentery in nine, the right mesocolon and retroperitoneum in one, the left mesocolon in one, and the jejunum, sigmoid-colon mesentery in one. Most of the patients underwent cyst excision, but six patients required concomitant bowel resection for complete removal of the lesions, and two patients underwent unroofing and simple aspiration respectively. There was one mortality case due to sepsis.

• Archives of Plastic Surgery
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• 제39권5호
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• pp.551-555
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• 2012

Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity, and the standard treatment is extensive surgical excision. Cesarean scar endometriosis is a type of cutaneous endometriosis arising on or near a Cesarean section scar. A 44-year-old woman presented with a $9{\times}6$ cm sized dark-brown, stony-hard, irregular, lower abdominal mass of four years duration. The patient had a history of two Cesarean deliveries, 14 and 16 years ago. Suspecting endometriosis, we excised the tumor conservatively rather than extensively to prevent incisional hernia considering the benign nature of the tumor and the low possibility of recurrence because the patient's age was near menopause, along with simultaneous bilateral salpingo-oophorectomy that was performed in this case. On reconstruction, mini-abdominoplasty was adopted to avoid possible wound complications and cosmetic deformities. The patient was satisfied with the cosmetic results, and neither recurrence nor functional problems occurred during the 1-year follow-up period. Plastic surgeons should keep in mind the possibility of cutaneous endometriosis in an abdominal mass of a female of reproductive age with a previous history of pelvic or intra-abdominal surgery. An optimal result from oncological, functional, and cosmetic standpoints can be achieved with conservative excision followed by mini-abdominoplasty of extensive Cesarean scar endometriosis.

• Clinical and Experimental Pediatrics
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• 제59권5호
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• pp.239-241
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• 2016

Choledochal cyst is a dilation that encloses the intrahepatic or both extra- and intrahepatic portions of the biliary ducts. Postnatally, ultrasonography is the initial diagnostic modality of choice, allowing for precise measurements of intra- or extrahepatic duct dilatation and identification of stones and sludge. Symptoms depend on the age at presentation. Common bile duct malformations should be considered as a differential diagnosis of a cystic mass regardless of the cyst's size or patient's age, especially in children presenting with abdominal pain, jaundice, and palpable mass. To the best of our knowledge, we report the largest choledochal cyst in infancy.

• 한국임상수의학회지
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• 제27권3호
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• pp.302-306
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• 2010

몇 일간 설사, 식욕부진 활력감소를 주 증상으로 보이는 개와 고양이가 내원하였다. 신체검사, 혈액검사와 더불어 영상학적 검사가 진행되었다. 복부 방사선 사진상 둥근 연부조직 밀도를 보이는 종괴가 중복부에서 확인 되었고 이는 복부 초음파 검사상 이질적 에코를 나타내는 것을 확인하였다. 세포학적 검사를 통해 염증으로 확인되었고, 수술적 제거 후 임상증상은 개선되었다. 조직 병리학적 검사 결과 육아종증 또는 호산구성 염증으로 확인되었다.

• Journal of Gastric Cancer
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• 제15권3호
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• pp.209-213
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• 2015

A 78-year-old man underwent laparoscopy-assisted total gastrectomy for gastric cancer (pT3N0M0). Multiple port sites were used, including a 10 mm port for a videoscope at the umbilical point and three other working ports. During the six-month follow-up evaluation, a 2 cm enhancing mass confined to the muscle layer was found 12 mm from the right lower quadrant port site, suggesting a metastatic or desmoid tumor. Follow-up computed tomography imaging two months later showed that the mass had increased in size to 3.5 cm. We confirmed that there was no intra-abdominal metastasis by diagnostic laparoscopy and then performed a wide resection of the recurrent mass. The histologic findings revealed poorly differentiated adenocarcinoma, suggesting a metastatic mass from the stomach cancer. The postoperative course was uneventful, and the patient completed adjuvant chemotherapy with TS-1 (tegafur, gimeracil, and oteracil potassium). There was no evidence of tumor recurrence during the 50-month follow-up period.

• The Korean Journal of Pain
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• 제8권1호
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• pp.159-163
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• 1995

Accidental high epidural block is a rare but serious complication. It can result from many factors, which include the volume and concentration of drug, posture, puncture site, age, pregnancy or intra-abdominal mass, and patients' height and weight. We had a case of accidental high epidural block recently. This is a case report which was confirmed by an epiduragram. A healthy 50-year-old woman with a huge uterine myoma was scheduled for a total abdominal hysterectomy under continous epidural analgesia. Epidural catheterization was carried out smoothly. However, an unexpected hypotension was noticed after an epidural injection of 2% lidocaine 25 ml. Thereafter, the patient was intubated and her respiration was controlled during the operation. Using the 5mg of ephedrine, her blood pressure and pulse were well maintained. The scheduled operation was carried out for one hour uneventfully, but after the operation, she felt paresthesia on her hands in the recovery room. To differentiate between the high epidural and the subdural blocks. We injected 5 ml of a water soluble Niopam 300 through the catheter postoperatively. It was observed on the epiduragram that the catheter was placed in the epidural space. It was suggested that the high epidural block was induced from the widespread diffusion through the narrowed epidural space due to the engorgement of the epidural venous plexus by the patient's huge uterine myoma.