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Penetrating gallbladder injury in a pediatric patient in the United States: a case report

  • Nelimar Cruz-Centeno;Shai Stewart;Derek R. Marlor;Charlene Dekonenko;Richard J. Hendrickson
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.295-297
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    • 2023
  • Penetrating gallbladder injuries are uncommon in the pediatric population. The treatment varies according to the severity of the injury and the patient's hemodynamics. We present the case of an 11-year-old male with an accidental pellet gunshot wound to the right upper abdomen that resulted in a grade III liver laceration and damage to the anterior gallbladder wall. The patient underwent laparoscopic cholecystectomy with drain placement. Postoperative radiography of the surgical specimen confirmed the presence of the pellet in the gallbladder. The patient recovered uneventfully and was discharged home on postoperative day 3. Laparoscopic cholecystectomy is a feasible treatment option for penetrating gallbladder injuries in hemodynamically stable patients.

A Case Report of Inflammatory Pseudotumor Involving the Clivus: CT and MR Findings

  • Jae Hee Lee;Kijun Kim;Sung Woo Chung;Yong Chul Choi;Ahnhi Lee
    • Korean Journal of Radiology
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    • v.2 no.4
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    • pp.231-234
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    • 2001
  • The authors describe a rare case of inflammatory pseudotumor involving the clivus, where a soft tissue mass lesion, with extension into the prevertebral retropharyngeal space and the cavernous sinuses, was detected by CT and MRI. The mass resembled a malignant tumor or aggressive infectious lesion, and the final diagnosis of inflammatory pseudotumor was a diagnosis of exclusion, decided after histopathological examination.

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Clinical Experience of Foreign Body Granuloma in the Apex of Orbit (안와첨부 이물 육아종의 치험례)

  • Paik, Hye Won;Choi, Jong Woo;Chong, Hyun Kwon;Lee, Paik Kwon;Ahn, Sang Tae
    • Archives of Plastic Surgery
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    • v.32 no.1
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    • pp.131-134
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    • 2005
  • It is often difficult to identify and localize intraorbital foreign bodies despite of modern high-resolution imaging investigation. Especially, posteriorly located foreign bodies have increased risks of morbidity that surgical approach is often complicated. No matter how trivial it seems, retained foreign body, particularly organic in nature, may give rise to severe orbital and cerebral complications. High clinical suspicion, proper diagnostic studies, timely referral to a skilled orbital surgeon are mandatory. We report a case of intraorbital wooden foreign body that required two separate exploration for removal. Initial exploration failed to identify and locate the foreign body completely. After the operation, fistula formation and purulent discharge were developed and the imaging investigation results were equivocal, complicating the management. A second exploration yielded multiple intraorbital wooden foreign body in the apex of orbit. The patient fully recovered without complication. The evaluations and the details of management strategy are discussed.

A Case of Astroblastoma

  • Han, Young-Min;Kim, Jong-Tae;Chung, Dong-Sup;Park, Young-Sup
    • Journal of Korean Neurosurgical Society
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    • v.40 no.5
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    • pp.373-376
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    • 2006
  • An astroblastoma is a rare primary glial tumor occurring preferentially in young adults. It is characterized by a perivascular arrangement of the tumor cells forming perivascular pseudorosettes mimicking ependymomas. The histogenesis of astroblastoma is unclear, despite a number of studies to determine its possible cellular origin. We have experienced a case of astroblastoma located at the temporal lobe. It presented as a large, well-circumscribed, and highly enhanced mass lesion on magnetic resonance images[MRI]. The tumor was well demarcated and did not infiltrate the brain, which made complete removal possible. Here, we report and discuss the characteristic histological and radiological features of this case.

Sacral Insufficiency Fracture, Usually Overlooked Cause of Lumbosacral Pain

  • Lee, Yong-Jeon;Bong, Ho-Jin;Kim, Jong-Tae;Chung, Dong-Sup
    • Journal of Korean Neurosurgical Society
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    • v.44 no.3
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    • pp.166-169
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    • 2008
  • Sacral insufficiency fractures are usually known to develop in elderly patients with osteoporosis without definite trauma history. It is difficult to diagnose the sacral insufficiency fracture at an early stage because lower lumbar diseases. concurrently or not, may also be presented with similar symptoms and signs. We report a rare case of sacral insufficiency fracture who was not diagnosed initially but, instead, showed progressively worsening of clinical symptoms and radiological findings after decompression surgery for upper level lumbar stenosis.

Surgical Treatments for Cervical Spondylotic Myelopathy Associated with Athetoid Cerebral Palsy

  • Lee, Yong-Jeon;Chung, Dong-Sup;Kim, Jong-Tae;Bong, Ho-Jin;Han, Young-Min;Park, Young-Sup
    • Journal of Korean Neurosurgical Society
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    • v.43 no.6
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    • pp.294-299
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    • 2008
  • Objective : To evaluate the clinical characteristics and surgical outcomes of the patients with cervical spondylotic myelopathy associated with athetoid cerebral palsy. Methods : The authors reviewed the clinical and neurodiagnostic findings, surgical managements and outcomes in six consecutive patients with cervical spondylotic myelopathy associated with athetoid cerebral palsy who had been treated with surgical decompression and fusion procedures between January 1999 and December 2005. The mean age of the 6 patients (four women and two men) at the time of surgery was 42.8 years (range, 31-55 years). The mean follow-up period was 56.5 months (range, 17-112 months). The neurological outcome was evaluated before and after operations (immediately, 6 months after and final follow-up) using grading systems of the walking ability, brachialgia and deltoid power. Results : At immediate postoperative period, after 6 months, and at final follow-up, all patients showed apparent clinical improvements in walking ability, upper extremity pain and deltoid muscle strength. Late neurological deterioration was not seen during follow-up periods. There were no serious complications related to surgery. Conclusion : Surgical decompression and stabilization in patients with cervical spondylotic myelopathy associated with athetoid cerebral palsy have been challenging procedure up to now. Our results indicate that early diagnosis and appropriate surgical procedure can effectively improve the clinical symptoms and neurological function in patients with cervical spondylotic myelopathy and athetoid cerebral palsy, even in those with severe involuntary movements.

A Case of Tuberculous Peritonitis Diagnosed by Colonoscopic Biopsy (대장 내시경 생검으로 진단된 결핵성 복막염 1례)

  • Park, Hye Jin;Lee, Su Min;Kim, Sun Mi;Jeong, Dae Chul;Chung, Seung Yeon;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.11 no.1
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    • pp.131-135
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    • 2004
  • Tuberculous peritonitis is a rare cause of intra-abdominal infection. Although sometimes asymptomatic, most of the patients have fever, weight loss, abdominal pain, and edema. The diagnosis of tuberculous peritonitis is difficult and sometimes delayed because of confusion of the disease with other illnesses and the non-specificity of signs and symptoms. Tuberculous peritonitis is examined with ultrasonography and computerized tomogram, but confirmed by biopsy or tuberculosis culture. Ascitic fluid is exudates with a lot of lymphocytes and elevated protein. Tuberculous peritonitis is treated successfully with isoniazid, rifampicin for one year, pyrazinamide for first 2 months and streptomycin for first one month. We experienced one case of tuberculous peritonitis with transudate of ascitic fluid, confirmed by biopsy using colonoscopy, and treated successfully.

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Preliminary Experience with Cervical Implantable Titanium Cage(RABEA) in Patients with Monosegmental Degenerative Disease : Clinical and Radiological Outcomes without Cancellous Bone Filling into Cage (단일 분절 퇴행성 경추질환에서 Titanium Cage를 이용한 전방 융합술의 조기 치험 : 골편 이식을 동반하지 않은 경우의 임상적 방사선학적 초기 결과)

  • Lee, Young-Kyun;Han, Young-Min;Kim, Jong-Tae;Chung, Dong-Sup;Park, Young-Sup;Park, Chun-Kun;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.300-308
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    • 2001
  • Objectives : Anterior cervical discectomy and interbody fusion has become a well-accepted surgical treatment of degenerative cervical diseases. Implatable cages have a stabilizing effect without plates and no need for autogenous bone graft. The authors evaluates the effect of implatable titanium cage(RABEA) on the clinical and radiological outcomes. Methods : 34 patients with symptomatic cervical degenerative diseases due to one level disc pathology were underwent anterior cervical discectomy and interbody fusion with titanium cages(RABEA) which were not filled with cancallous bone grafts from January 1999 to May 2001. Patients with osteoporosis and older than 65 years were not included. Among them, 15 patients could be followed-up for at least 1 year. The authors retrospectively reviewed the charts and radiographic data. Mean follow-up period was $1.3{\pm}0.2years$. Results : Clinical results according to the Odom's criteria was exellent and good in 14(93%) patients. One patient with fair result showed complete loss of the disc space height due to settlement of the cage. Preoperatively, the mean height of the disc space(${\pm}$standard deviation) was $3.42{\pm}1.10mm$(range 2.0-5.5mm), and at 1 day postoperatively it was $7.88{\pm}0.90mm$(range 6.50-9.0). The mean height of the disc space after 1 year was $6.50{\pm}1.38mm$(range 3.0-8.0). The restoration of the height was statistically significant(p<0.05). The mean height after 1 year was $82.7{\pm}15.9%$ of the height at 1 day postoperatively. Preoperatively the mean value of the cervical lodortic angle was $21.8{\pm}11.8^{\circ}$ and 1 year postopertively, it was $24.5{\pm}8.3^{\circ}$, which was statistically not significant. All patients showed no abnormal movements on flexion and extension lateral film after 6 months. Conclusion : Implantable titanium cages appear safe and effective in selected patients, and their use helps to avoid complications associated with bone graft harvest. Subsidence of the cage seems to be a potential risk factor for recurrence of the symptoms. For long-term results, a longer follow-up is required.

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A Case of Vocal Cord Hemangioma (성대에 발생환 혈관종 1예)

  • Jeon, Eun-Ju;Park, Yong-Soo;Lee, Seung-Kyun;Kim, Dong-Kee
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.15 no.1
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    • pp.52-54
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    • 2004
  • Hemangioma of the larynx is generally classified into adult and infantile form. More common infantile form usually arises on subglottic portiion and may cause respiratory distress. Adult form is rare and arises on vocal cord or above. Vocal cord hemangioma was rarely reported in the medical literature. Since Kimmelman et al reported vocal hemangioma in 1979 first, there are four cases of vocal hemangioma reported in medical literature. Recently, we experienced a case of vocal cord hemangioma and successfully removed it with micro-laryngeal surgery. Hence we report this case with review of literatures.

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