• Journal of Chest Surgery
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• 제24권12호
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• pp.1238-1241
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• 1991

Agenesis of the hemidiaphragm is unusual congenital anomaly associated with a high mortality. A case of congenital agenesis of left diaphragm was experienced in 22-day old male patient who was dyspneic and cyanotic on admission. Emergency exploration through the left eight interspace thoracotomy showed complete agenesis of the left diaphragm. The stomach and transverse colon covered with peritoneal sac was partially herniated into left hemithorax. The left lung was slightly hypoplastic. This neonate had no intestinal malrotation. The defect was reconstructed using Dacron graft. Dacron patch was sutured with interrupted Ethibond to chest wall anteriorly, esophagus aorta and costomediastinal sinus medially, and the tenth rib posterolaterally. Postoperatively, Extubation was performed at 1st day, but some respiratory difficulty was noted. Severe dyspnea was occurred at postoperative 11th day and so reintubation was done. Intermittently ventilatory support and intravenous alimentation were continued for 9 days after that. Thereafter he had no respiratory problems at discharge.

• Journal of Korean Neurosurgical Society
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• 제44권4호
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• pp.240-244
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• 2008

Objective : Sotos Syndrome is characterized by macrocephaly, overgrowth, and developmental delay, and more than 300 patients have been reported worldwide to date. The authors reviewed the clinical characteristics of 8 patients with Sotos Syndrome in Korea for a new understanding and treatment strategies. Methods : The medical records of a total of eight Korean children with Sotos Syndrome were reviewed. All patients underwent developmental checkup, lumbar punctures for measurement of intracranial pressure (ICP), brain and spine magnetic resonance imaging and computerized tomography. Results : All 8 patients showed macrocephaly and the characteristic craniofacial features of Sotos Syndrome. Other clinical characteristics shown were overgrowth (7/8), developmental delay (7/8), congenital heart defect (3/8), flat foot (8/8), scoliosis (4/8), spina bifida (8/8), hydrocephalus (4/8), cavum vergae (3/8), and increased subdural fluid collection (5/8). Mean ICP measured via lumbar puncture was $27.35{\pm}6.25\;cm$ $H_2O$ (range 20 to 36 cm $H_2O$). Two patients received ventriculo-peritoneal shunt, and 1 patient underwent subduro-peritoneal shunt with improvement. Spinal orthosis was applied to 4/5 patients with scoliosis and 4/8 children with flat foot were provided with foot orthosis. Conclusion : In this first Korean study of 8 Sotos Syndrome patients we demonstrated the presence of spina bifida and increased ICP, which had not been previously described. The authors therefore suggest that all patients with Sotos Syndrome should undergo examination for the presence of spina bifida, and that shunt procedures would improve development and alleviate clinical symptoms.

• Clinical and Experimental Reproductive Medicine
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• 제12권1호
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• pp.47-70
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• 1985

This study was presented of the 1,872 cases of infertile couples who visited and examined at the sterility clinic of Department of Obstetrics & Gynecology, Seoul National University Hospital from Sept., 1980 to Dec., 1983. Age, duration of infertility, past medical history, and other general factors were analyzed, and the factors responsible for infertility were classified and discussed. Mode of treatment, outcome of pregnancy, pregnancy rate responsible for each factor were also presented. The results were as follows: 1) The infertility was primary in 1,128, or 60.3% and secondary in 744, or 39.7%. 2) The age between 26 and 30 years of age comprised about one half of the total patients. 3) The duration of infertility between 1 and 4 years comprised about three quarters of the total patients, and the mean duration was 3.8 years. 4) The most common medical history in primary infertility was tuberculous disease, and that in secondary infertility was history of previous laparotomy. 5) About two thirds of antecedent pregnancies were abortion. 6) The major etiologic factor of infertility were male factor in 12.3%, tubal factor in 38.8%, ovulatory failure in 25.4%, uterine factor in 8.8%, cervical factor in 5.2%, peritoneal factor in 9.5%, and no demonstrable cause in 11.3%. 7) The types of male factor were azoospermia in 61.6%, oligospermia in 25.8%, low motility in 11.6%, and other abnormality in 1.0%. 8) The types of ovulatory failure were ovarian failure in 7.4%, hypothalamo-pituitary failure in 8.1 %, hypothalamo-pituitary dysfunction (including Polycystic ovarian syndrome) in 30.2%, and hyperprolactinemia in 22.4%. 9) The types of uterine factor were endometrial tuberculosis in 27.5%, uterine synechia in 33.8%, uterine anomaly in 19.7%, myoma and polyp in 9.1 %, and luteal phase defect in 9.9%. 10) The types of peritoneal factor were pelvic adhesion in 80.9% and endometriosis in 19.6%. 11) Surgeries were done in 408 patients, and they were salpingolysis, lysis of extraadnexal adhesion, salpingostomy, fimbrioplasty, ovarian wedge resection for polycystic ovarian disease, tubo-tubal anastomosis, and tubo-uterine implantation in orders. 12) 243 pregnancies were achieved during the infertility work-up, of which livebirth was 46.5%, ectopic pregnancy was 7.4%, spontaneous abortion was 7.8%, and on-going pregnancy or lost to follow-up was 36.2%. 13) Pregnancy rates in various factors were male factor in 18.7%, ovulatory factor in 31.7%, tubal factor in 24.2%, uterine factor in 34.6%, cervical factor in 19.0%, peritoneal factor in 29.0%, combined factors in 10.5%, and unexplained infertility in 37.1%. Pregnancy rate in whole patients was 25.2%.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.655-662
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• 2011

Purpose: The anterolateral thigh flap is versatile flap for soft-tissue reconstruction for defects located at various sites of the body. This useful flap offers a thick and vascular fascia lata component with large amounts that can be soft tissue coverage for different reconstructive purposes. We present our clinical experience with the use of vascular fascia lata, combined with anterolateral thigh flap for various reconstructive goals. Methods: From April 2008 to February 2011, we transferred anterolateral thigh flaps with fascia lata component to reconstruct soft-tissue defects for different purposes in 11 patients. The fascia lata component of the flap was used for tendon gliding surface in hand/forearm reconstruction in 4 patients, for reconstruction medial and lateral patellar synovial membrane and retinaculum in 2 patients, for reconstruction of plantar aponeurosis in the foot in 2 patients, for reconstruction of fascial and peritoneal defect in the abdominal wall in 2 patient, and for dural defect reconstruction in the scalp in the remaining one. Results: Complete loss of the flap was not seen in all cases. Partial flap necrosis occurred in 2 patients. These complications were treated successfully with minimal surgical debridement and dressing. Infection occurred in 1 patient. In this case, intravenous antibiotics treatment was effective. Conclusion: Anterolateral thigh flap has thick vascular fascia with large amounts. This fascial component of the flap is useful for different reconstructive aims, such as for tendon, ligament, aponeurosis defects, abdominal wall or dura reconstruction. It should be considerated as an important advantage of the flap, together with other well-known advantages.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2007년도 춘계학술대회
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• pp.151-151
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• 2007

• Journal of Chest Surgery
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• 제6권1호
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• pp.109-112
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• 1973

Bochdalek hernia is the most common congenital diaphragmatic hernia and that of the foramen of Bochdalek is rare in right side of the diaphragm. Two cases of right Bochdalek hernia were reported in literatures published in Korea. The first case was associated with hypoplasia of the lung and could not be survived. The second case [four months old male infant] was operated on August 28, 1971. at Ewha University Hospital arid survived. The third case was a three months old male infant who had been born at 8th lunar month in a private clinic. During the period of three months prior to admission this premature infant was suf-fered from mild respiratory distress measured as pneumonia. On December 20. 1972, this infant was admitted at Kyung Hee University Hospital with severe respiratory distress developed abruptly. Chest X-ray examination [barium study] demonstrated right diaphragmatic hernia. Right hemithorax was filled with intestines and right lobe of the liver which were repositioned back into the peritoneal cavity through the foramen of Bochdalek. 3. 0 cm x3.5 cm in size, and the defect was closed with interrupt mattress sutures. There was hypospadia with chordee but no other associated anomalies such as hypoplasia of the lung, malrotation or malfixation of intestines, and cardiovascular anomalies. The Postoperative hospital course was not eventful and the baby was discharged on the 14th postoperative day.

• Toxicological Research
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• 제11권1호
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• pp.15-21
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• 1995

Several populations of lymphocytes possess receptors for autonomic neurotransmitter, which make lymphocytes susceptible to autonomic stimulation. This study was to evaluate the functional alternation of effector cells of the immune system. Female Balb/C mice, 15-20 g, were injected with MA subcutaneously under various conditions. Mixed lymphocyte reaction (MLR) showed certain T cell subsets were affected by MA. The level of interleukin-2 (IL-2) production was inhibited due to a defect in expression of the IL-2 receptor. In mice injected with 20 mg MA/kg, 1 day before assay, phagocytosis of peritoneal macrophages showed $14.07\pm3%$, which was similar degree to 5 mg MA/kg treatment for 4 consecutive days. Phagocytosis was almost recovered to that of control after 4 day in 20 mg/kg injected mice. Maximum inhibition of plaque forming cell (PFC) occurred when MA was given early, indicating the inductive time point of antibody production was affected. The cortisol level increased in the MA treated group (0.05, 0.20, and $0.08{\mu}g$/dl for control, low, and high dose-MA treated mice, respectively). Based on these results, MA has general suppression effects on the immune systems by functional alteration of effector cells. Considering the increment of serum cortisol levels, MA partially impacts the neuroendocrine system to lead to failure of immune response.

• Neonatal Medicine
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• 제17권2호
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• pp.254-261
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• 2010

신생아에서의 미토콘드리아 질환은 임상 증상이 다양하고 비특이적이라 진단이 어렵고, 치명적으로 생존율이 낮기 때문에 이에 대한 연구는 미비하다. 본 연구에서는 신생아기에 미토콘드리아 질환 소견으로 치료한 3례를 보고하였다. 증례 1은 갑작스럽게 발생한 강직성 경련, 의식 소실 및 심한 대사성 산증과다기관 기능 부전으로 미토콘드리아 병증이 의심되었다. 혈장내 젖산/피루브산염 비가 55.6, 아미노산 검사에서는 알라닌 2,237 nmol/ml로 증가되었다. 증례 2에서는 급성 부신기능부전과 급성 신부전으로 복막 투석을 하였으나 대사성 산증이 지속되었다. 혈장 내 젖산/피루브산염 비가 23.9였고, 근 조직을 이용한 효소 분석에서 1번 복합체의 호흡 사슬 결함이 진단되었다. 증례 3은 출생 후 2개월간 반복되는 대사성 산증과 기면, 수유 곤란 소견을 보였다. 혈장 내 젖산/피루브산염 비가 19.4로 정상 범위의 경계에 있었으나 뇌척수액 검사상 젖산/피루브산염 비가 57로 현저하게 증가된 소견을 보였고, 뇌 자기 공명 분광경 검사에서 lactate peak 소견을 보였다. 근 조직을 이용한 효소 분석에서 2번 복합체의 호흡 사슬 결함이 진단되었다. 세증례 모두에서 미토콘드리아 질환 소견으로 비타민, 조효소 Q10 및 L-카르니틴을 투여하였다.

• 한국임상수의학회지
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• 제27권5호
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• pp.600-604
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• 2010

10년령의 암컷 잡종견이 식욕부진, 쇠약, 혈색소뇨를 주증으로 충북대학교 동물의료센터에 내원하였다. 환자는 내원 하루 전 지역동물병원에서 효소 면역 측정법에 의해 심장사상충증을 진단 받았으며 성충구제제를 투여 받았다. 혈액검사를 통해 저색소성 소적혈구성 재생성 빈혈과 혈소판감소증, 중등도의 호중구증가증, ALT AST ALP의 상승이 확인되었다. 방사선 촬영을 통해 주페동맥의 확장, 폐침윤, 복부 선예도 감소, 경증의 간비대가 확인되었다. 복부 초음파 검사에서 경증의 복수, 간문 수준의 문정맥과 비장정맥에서 고에코성의 혈전이 확인되었다. 조영 증강 컴퓨터 단층촬영을 통해 문정맥 내강내 저밀도 영역과 혈관내 충진결손을 확인하였다. 환자는 항응고제와 혈전용해제로 치료를 받았으며, 42일 동안의 치료 후 혈전의 완전한 용해를 복부 초음파 검사를 통해 확인하였으며 임상 증상의 개선이 관찰되었다.

• Journal of Chest Surgery
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• 제29권8호
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• pp.828-835
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• 1996

1993년 1월 부터 1995년 4월까지 2년 4개 월동안 본 교실에서 시술한 신생 아개심술 총 27례를 대상으로 조사하였다. 남아가 16명. 여아가 11명이 었고 평균나이는 12.1일이며 생후 2일부터 30일까지였다. 체중은 평균 3.29kg이었고 최저 2.6kg에서 최고4.1 kg이었다. 심기형은 대혈관전위증이 11례, 대혈관전위증과와 대동맥축착증 및 심실중격 결손증을 동반한 기형이 1례, 총폐 정 맥환류이 상증이 5례, 총폐정 맥환류이상증이 동반된 단심실증(Double inlet right ventricle)이 I례, 심실중격결손증을 동반한 대동맥 차단중이 )례. 온전한 심실중격과 폐동맥 폐쇄증 및 폐동맥 판협 착 증이 각각 3례, 1례였고 대동맥궁차단증이 동반한Taussig-Binganomaly와 좌심형성부전증후군 이 각각 1례 씩 이 있다. 총 27명의 환아 중 20명(74.1%)에서 각종 합병증이 발생하여 높은 합병증 발생률을 보였으며 가장 빈 발한 합병증은 지연흉골봉합이 필요하였던 심근 및 폐부종이었다 심폐기 이탈이 불가능하였던 )례를 제외한 24례중 13례(54.2%)에서 심근 및 폐 부종으로 흉골을 봉합하지 못하고 심중환자실로 나왔으며 4례는 지연흉골봉합 이 전에 저 박출증으로 사망\ulcorner였고 9례는 모두 술후 3일째 흉골봉합을 하고 모두 생존 하였다 두번째 빈발한 합병증으로는 급성신부전으로 10례(37%)에서 발생하였으며 이중 7례에서는 복 막투석으로 회복되 었다. 심한 저 박출증은 모두 7례(25.9%)에서 발생하였는데 3명은 심폐 기로 부터 이탈 이 불가능하였다. 그 외 합병증으로 발작성 상심실 빈맥증(paroxysmal supraventricular tachycardia). 기 관지 폐이형성(bronchopulmondry dysplasia), 창상감염이 각각 1례씩 발생하였으나 극복되 었다. 모두 8명의 환아가 사망하여 29.6%의 수술사망률을 나타내었다. 사망원인은 저 박출증이 7례, 신부전이 3례았다. 심기형에 따른 수술사망은 대혈관전위증의 동맥전환술후 3례, 대동맥축착증이 동반된 대혈관 전위증의 1차 완전교정술에서 1례, 촐폐정 맥환류이상증을 동반한 단심 실증 환아에서 총폐 정 맥 환류이 상 증교정과 폐동맥교약술 후 1례, 대동맥궁차단증이 동반된 Taussig-Bing anomaly의 1차 완전교정술 후 1 례, 온전한 심실중격과 폐동맥 폐쇄증의 우심실유출로 성 형술 후 1례, 좌심 형 성 부전증후군의 Norwood operation 후 1례 였다. 저자들의 신생아 개심술에 대한 초기경험으로서 높은 수술사망율과 합병증 발생율을 나타내었고 특 히 신생 아의 복잡심기형에서는 사망율이 매우 높았다.