• Title/Summary/Keyword: stricture

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A Case of Intestinal Perforation in Henoch-Schönlein Purpura (Henoch-Schönlein 자반증에서 발생된 장천공 1례)

  • Kang, Won Sik;Oh, Chang Hwan;Kim, Jae Young;Lee, Young Taek;Lee, Hye Jin;Kim, Hee Jin;Kim, Sung Won
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.406-412
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    • 2002
  • Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is one of the most common vasculitic diseases of childhood, referred to as a leukocytoclastic vasculitis affecting small vessels. Although HSP related gastrointestinal symptoms are seen in up to 80% of patients during acute illness, these symptoms are usually transient. However, some patients with HSP have gastrointestinal major surgical complications such as intussusception, bowel infarction, necrosis, stricture, and perforation. We experienced a rare case of HSP-related ileal perforation developed after corticosteroid treatment. We report a case with HSP-related intestinal perforation and assess the effect of corticosteroid on the outcome of abdominal pain in children with HSP.

Esophageal Perforation: 9 Cases (식도천공 9례 보고)

  • Lee, Hong-Seop;Yu, Hoe-Seong
    • Journal of Chest Surgery
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    • v.11 no.1
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    • pp.85-91
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    • 1978
  • H.S. Lee, M.D., H.S. Yu, M.D. Esophageal perforation occurred rarely but often lead to a high mortality and morbidity. In the past, the main cause of esophageal perforation in Korea were instrumental perforation in patient with lye stricture of the esophagus. We experienced 9 cases of other forms of esophageal perforation from 1972 through 1977 and obtained the following results. 1. These 9 patients ranged from 10 months to 40 years in age at the time of admission. Six were women. 2. Causes of perforation are instrumental perforation in 3, foreign body perforation in 3, spontaneous perforation in 3 and one pneumatic esophageal perforation. 3. Perforation developed in a variety of locations in the esophagus. Three occurred in cervical part, two in the upper thoracic part, two in the lower thoracic part. 4. The main clinical symptoms and signs were dyspnea, subcutaneous emphysema, chest pain and fever. 5. Thoracic rentgenogram disclosed subcutaneous and mediastinal emphysema, widening of mediastinum and pleural effusion at the time of admission. 6. Complications of esophageal perforation were mediastinitis [7 cases], empyema [4 case], respiratory distress [4 cases] and sepsis [3 cases]. 7. In 3 deaths of the nine patients who sustained perforation of the esophagus, one was due to transfusion of infected blood and two of them were due to sepsis following empyema and mediastinitis. Early treatment [less than 24 hr] gave no hospital death, and good results obtained in the perforations of cervical and upper thoracic esophagus.

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Esophageal Replacement with Transhiatal Gastric Transposition In the Long Gap Esophageal Atresia - Report of Two Cases - (원간격결손 식도페쇄증에서 경열공적 위전위법을 이용한 식도재건술)

  • Han, Seok-Joo;Kim, Sung-Do;Kim, Choong-Sai;Oh, Jung-Tak;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.3 no.2
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    • pp.152-159
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    • 1997
  • Transhiatal gastric transposition was performed in two case of long gap esophageal atresia without tracheoesophageal fistula. The patients were a 12 months old female and an 18 months old male. Stamm type gastrostomies were performed at other hospitals in both cases. The stomach was mobilized preserving the right gastric artery, the right gastroepiploic artery and spleen. A portion of the proximal and the distal esophageal segment were excised by transcervical and transhiatal route, respectively. The mobilized stomach was pulled up to the neck through the esophageal hiatus and posterior mediastinum. The esophagogastrostomy, the only one anastomosis of this procedure, was performed in the neck. There was no clinical evidence of anastomotic leakage, stricture, regurgitation, difficulty of gastric emptying, hoarseness or respiratory problem. Transhiatal gastric transposition seems to be a safe and easy alternative surgical procedure for esophageal replacement in long gap esophageal atresia.

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Effects of Structured Arm Exercise on Arteriovenous Fistula Stenosis in Hemodialysis Patient (구조화된 상지운동이 혈액투석 환자의 동정맥루 협착에 미치는 효과)

  • Kim, Aee Lee
    • Journal of Korean Biological Nursing Science
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    • v.14 no.4
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    • pp.300-307
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    • 2012
  • Purpose: The purpose of this research was to develop and prove the effectiveness of structured arm exercise, which was used to reduce Arteriovenous Fistula (AVF) and Arteriovenous graft (AVG) stricture of hemodialysis patients. Methods: Quasi-experimental research design with non-equivalent control group was applied. 26 Subjects were participated in this study. 12 of hemodialysis patients who do not have a normal range of Static Intra Access Pressure Vein (SIAPV) score in the last three months were assigned to the experimental group and 14 patients who have a normal range of SIAPV score in the last three months to the control group. To analyze the collecting data after structured arm exercise, non parametric method with the repeated measures ANOVA by the Friedman test and Wilcoxon Signed Ranks Test for post-hoc test was performed. Results: Unlike the experimental group after three months, the control group's SIAPV data went over the normal range. The experimental AVF group showed a difference in data after month 2 and month 3. - In AVG group, there were clear differences in each month of the test. Conclusion: This study proved that structured arm exercise therapy could be a simple and effective intervention. It is suggested to be actively utilized for hemodialysis patients.

A Case of Autoimmune Chronic Pancreatitis in a Child (자가면역성 만성 췌장염으로 진단된 소아 1예)

  • Choi, In-Young;Jin, So-Hee;Choi, Kyung-Dan;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.215-220
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    • 2007
  • We present a case of autoimmune chronic pancreatitis in a previously healthy child without any history of autoimmune disease. A 12-year-old boy was admitted to the hospital with abdominal pain. The serum amylase, lipase, and IgG levels were elevated and autoantibodies (antinuclear antibody, antineutrophil antibody) were detected. An abdominal CT (computed tomographic) scan revealed diffuse enlargement of the pancreas. ERCP (endoscopic retrograde cholangiopancreaticography) demonstrated an irregular stricture of the main pancreatic duct in the pancreas tail. After two years of oral steroid and immunosuppressive drug therapy, the clinical, laboratory and radiological findings were improved. The patient has been symptom-free for 18 months after the discontinuation of medication.

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A Taxonomy of National Systems of Innovation based on the R&D stricture of OECD member economies (국가혁신체제의 유형분류 - OECD회원국의 연구개발구조를 중심으로-)

  • 박용태
    • Proceedings of the Technology Innovation Conference
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    • 1998.06a
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    • pp.208-215
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    • 1998
  • Since the advent of conceptual prototype and seminal application, the notion of national systems of innovation(NSI) has drawn an increasing recognition. Although the morphological entanglement is still ubiquitous and the theoretical underpinning is fragile, NSI seems to be the last step toward an increasingly complex and encompassing concept of innovation research. Inevitably, NSI necessitates the comparative analysis in that it normatively attempts to draw best practices. Unfortunately, national profiles are too complex and diverse to derive a unified, concrete representation of the system, posing the problem of defining and modelling NSI for international comparison. This paper aims at providing an inductive taxonomy of NSI based on R&D structure of OECD member economies. Based on the similarity among national profiles, clustering method was applied to identify seven clusters such as (1) enterprise-government funding and enterprise-education performing group, (2) enterprise-government funding and balanced performing group, (3) balanced funding and enterprise-education performing group, (4) balanced funding and performing group, (5) enterprise-dominating group, (6) government-education dominating group and (7) government-education funding and education performing group. This paper by nature is descriptive and exploratory. R&D structure represents a static snapshot of innovative performance since it accounts for only the input side of NSI and thus may not offer convincing explanations of the holistic innovation system. A more detailed and extensive analysis on the economic/technological performance across clusters will shed light on the promising avenue to future research.

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Surgical Treatment of Esophageal Cancer (식도종양의 외과적 치료)

  • 육을수
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.170-176
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    • 1995
  • Fourty nine patients out of 127 esophageal cancer were managed surgically from January 1986 to December 1991, at the Department of Thoracic and Cardiovascular Surgery, Jeonbuk National University Hospital. Most frequent preoperative symptom was dysphagia and its mean duration was 3.1 months. In histopathologic examination, squamous cell carcinomas were 44 cases [89.8% , and adenocarcinomas 5 [10.2% . The tumor location were the upper esophagus in 6.1%, middle esophagus in 57.2%, lower and cardiac portion of stomach in 36.7%. Involved and metastatic organs, which were detected perioperatively, were celiac lymph nodes in 6 cases, aorta 2, stomach 2, pericardium 2, cervical lymph node 1. The esophagus was resected radically, and the procedures for esophageal replacement were performed with esophagogastrostomy in 45 cases, esophagocologastrostomy 3, and esophagojejunostomy 1. Postoperative complications occurred in 16 cases [hospital morbidity = 32.6% ,anastomotic leak 3, anastomotic stricture 2, respiratory insufficiency 2, hemoperitoneum 1, chylothorax 1, intussusception 1, empyema 1, non-A,non-B hepatitis 1, and mediastinitis 1. Hospital deaths were experienced 3 cases [ hospital mortality = 6.1% . The 6 month, one, two, and five year actuarial survival rates were 85.7%, 71.4%, 57.1%, and 27.9%, respectively. One year survival rates of stages were 100% in stage I, 90.9% in stage IIa, 63.6% in stage IIb, 25.0% in stage III, and 7.2% in stage IV.

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Urethroplasty in Male Pseudohermaphroditism (남성 가성반음양 환자에서의 요도성형술)

  • Kim, Seok Kwun;Ha, Jae Seong;Lee, Keun Cheol;Park, Jung Min
    • Archives of Plastic Surgery
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    • v.32 no.1
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    • pp.110-116
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    • 2005
  • Male pseudohermaphroditism is individuals with Y chromosome whose external appearances fail to develop as expected as a normal male. Cytogenetic form of male pseudohermaphroditism was 46XY but external genital forms were variable. We reviewed data from 7 patients with male pseudohermaphroditism operated in Dong-A University Hospital from January 1996 to August 2002. They all had severe form of hypospadias (pseudovaginal perineoscrotal type). Only 1 of 7 cases was operated urethroplasty by one stage method, and all others by two stage method. Patients with mild chordee were operated by one stage method and patients with severe chordee were operated by two stage method. Complete chordee release was done by Z-plasty or FTSG on the first stage and posterior urethroplasty was done at level of mid-dorsum of shaft at the same time. Anterior urethroplasty was done completely on the second stage. Results were good from the viewpoint of shape and urination. Urethral fistula occurred in two cases, but other complications (infection, urethral stricture, etc.) didn't occur. In conclusion, two stage method was compatible to correct hypospadias in male pseudohermaphroditism, because hypospadias in male pseudohermaphroditism is in severe form.

Surgical Treatment of Spontaneous Rupture of the Esophagus [Boerhaave`s Syndrome] (식도 자연파열[Boerhaave 증후군]의 외과적 치료;2례 보고)

  • Kim, Keun;Chang, Bong-Hyun;Lee, Jong-Tae;Kim, Kyu-Tae
    • Journal of Chest Surgery
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    • v.25 no.8
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    • pp.812-818
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    • 1992
  • The spontaneous rupture of the esophagus is an uncommon disease, but without early diagnosis and treatment, the mortality rate is high. This report is on the two cases treated at the Department of Thoracic and Cardiovascular Surgery, College of Medicine, Kyu-ngpook National University. The first patient, after heavy drinking, had vomiting followed by chest pain, dyspnea and subcutaneous emphysema. After diagnosis using an esophagogram, an operation was perfomed. About a 4cm rupture was found at the lower left part of the esophagus and was primarily sutured with the intercostal muscle. The patient was weaned from the ventilator after 40 hours. The second patient had symptoms the same as the first case. Six days after the app-earence of the symptoms, the patient was treated by the Thais onlay gastric patch method. The leakage happened after the surgery and he received a conservative treatment. After discharge no abnormalities, such as leakage and stricture, were found on the eso-phagogram The two patients now live a normal life.

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Vascularisation of Urethral Repairs with the Gracilis Muscle Flap

  • Kua, Ee Hsiang Jonah;Leo, Kah Woon;Ong, Yee Siang;Cheng, Christopher;Tan, Bien-Keem
    • Archives of Plastic Surgery
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    • v.40 no.5
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    • pp.584-588
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    • 2013
  • Background The ability to achieve a long-term, stricture-free urethral repair is one of the ongoing challenges of reconstructive urologic surgery. A successful initial repair is critical, as repeat procedures are difficult, owing to distortion, scarring, and short urethral stumps. Methods We describe a technique in which the gracilis muscle flap is laid on or wrapped around the urethral repair site to provide a well-vascularised soft tissue reinforcement for urethral repair. This technique promotes vascular induction, whereby a new blood supply is introduced to the repair site to improve the outcome of urethral repair or anastomotic urethroplasty. The surface contact between the muscle flap and the repair site is enhanced by the use of fibrin glue to improve adherence and promote inosculation and healing. We employed this technique in 4 patients with different urethral defects. Results After a follow-up period of 32 to 108 months, all of the urethral repairs were successful without complications. Conclusions Our results suggest that the use of a gracilis muscle flap to vascularise urethral repairs can improve the outcome of challenging urethral repairs.