• Journal of Yeungnam Medical Science
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• 제14권2호
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• pp.393-398
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• 1997

1987년 5월에서 1997년 10월까지의 영남대학교 의과대학 부속병원에서 임상적으로 선천성 중장 회전 이상을 의심하여 방사선학적으로 진단되고 수술을 시행한 17명의 환아를 대상으로 임상소견과 수술 기록 및 방사선학적 소견을 후향적으로 분석한 결과는 임상적인 주된 증상은 구토나 구토를 동반한 복통이었으며, 수술 소견상 16명의 환아에서 선천성 중장 회전 이상이 확진되었고, 1명의 환아에서 중장 회전 이상 없이 윤상 췌장으로 진단되었다. 모든 환아에서 상부 위장관 조영술과 바륨 관장술을 시행한 결과, type I인 경우가 3명, type IIA가 2명, type IIC가 1명, type IIIA가 5명, type IIIc가 4명이었으며 이중에서 type IA로 진단된 1명은 수술 소견상 윤상 췌장으로 확인되었다. 수술로 확진된 16명의 환아중 13명은 상부 위장관 조영 소견에서 선천성 중장 회전 이상이 진단되었고 3명의 환아에서는 상부 위장관 조영 소견은 확실하지 않았으나 바륨 관장 소견상 선천성 중장 회전 이상이 증명되었다. 결론적으로 선천성 중장 회전 이상은 중장 염전과 장 괴사와 같은 치명적인 합병증으로 출생 첫 주에 높은 사망률을 보이기 때문에 조기 진단이 매우 중요하며, 임상적으로 선천성 중장 회전 이상이 의심되면 상부 위장관 조영술을 먼저 실시해야 하고 십이지장 공장 접합부가 정상적으로 위장 유문부와 같은 축상에 있는지 우측 측사위 촬영에서 확인해야된다. 비록 정상 소견을 보일지라도 위음성이 있을 수 있으므로 반드시 바륨 관장술을 실시해서 압박, 사위, 좌측와위 촬영에서 맹장과 회장 말단부의 위치를 확인해야 될 것으로 생각된다.

• 한국임상수의학회지
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• 제38권5호
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• pp.231-234
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• 2021

A 14-month-old, intact female Maltese (case 1) and a 26-month-old, spayed female Dachshund (case 2) had persistent regurgitation over 1 year and 2 years, respectively. In both cases, there were not specific findings in blood examination. Diagnostic imaging and fluoroscopy revealed that gastroesophageal reflux (GER) occurred when the patients ate a barium meal without abdominal contraction. They were treated with proton-pump inhibitor (esomeprazole), sucralfate and prokinetics (cisapride) while in a standing position for an hour after every meal, according to the gastroesophageal disease (GERD) suggested treatment. The case 1 dog was discharged with improved clinical signs, and the case 2 dog also had been improved clinical signs; however, aspiration pneumonia occurred in case 2, which was thought to be a complication from GERD. After receiving treatment for aspiration pneumonia, the case 2 dog was discharged from the hospital. Since there was no further improvement in symptoms after discharge, the case 1 dog was euthanized by owner's request, and the case 2 is alive, having only mild clinical signs upon the writing of this paper.

• Archives of Pharmacal Research
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• 제25권6호
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• pp.978-983
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• 2002

Small intestinal transit (SIT) has often been regarded as an index of pathophysiological state of postoperative ileus (PI) in rats. The reliability of SIT as an index of PI was examined in the present study. PI was induced via abdominal surgery (i.e., laparotomy with evisceration and manipulation) in rats. For one group of PI-induced rats, SIT of a charcoal test meal was measured. When necessary, the physical state (i.e., severity and site of distension) of the gastrointestinal (GI) tract in each rat was visually examined. For another group of PI-induced rats, abdominal X-ray radiographs were obtained after introducing the barium sulfate suspension. The abdomen was then opened and the physical state of the GI tract was visually examined. The SIT was decreased in most of the PI-induced rats, and the GI distension was observed, with substantial intersubject variations, in all of the PI-induced rats. However, no linear relationship was evident between the SIT and the severity of GI distension (e.g., at 20 h after PI induction). Instead, the severity and site of GI distension could be monitored by the X-ray radiology. Therefore, the use of SIT as an index of PI should be substantially limited.

• Journal of Gastric Cancer
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• 제15권2호
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• pp.147-150
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• 2015

Gastric volvulus is an uncommon clinical entity. There are three types of gastric volvulus; organoaxial, mesenteroaxial and combined type. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report a successful case of a patient with chronic gastric volvulus with a laparoscopic treatment. A 79-year-old woman came to the emergency department with epigastric pain accompanied by nausea for 2 weeks. Abdominal computed tomography revealed markedly distended stomach with transposition of gastroesophageal Junction and gastric antrum. Barium meal study revealed presence of the antrum was folded over 180 degrees that was located above gastroesophageal junction. We attempted an endoscopic reduction, but it was unsuccessful. The patient got laparoscopic anterior gastropexy. Based on our result, laparoscopic gastropexy can be considered as a good choice of the treatment for gastric volvulus.

• Advances in pediatric surgery
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• 제20권2호
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• pp.65-68
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• 2014

Congenital duodenal obstruction is a one of the emergent surgical conditions in neonates. Almost of them were diagnosed with double-bubble sign in prenatal ultrasonography. However, partial obstruction caused from duodenal web could be overlooked. We reported a duodenal web in early childhood. A three-year-old girl visited at our pediatric clinic for constipation. She had been showed non-bilious vomiting after weaning meal since 6 months old of her age, but her weight was relevant for 50-75 percentile of growth curve. Barium enema was initially checked, but any abnormal finding was not found. We noticed the severely distended stomach and 1st portion of duodenum. Upper gastrointestinal series revealed partial obstruction in 2nd portion of duodenum. After laparotomy, we found the transitional zone of duodenum and identified a duodenal web via duodenotomy. We performed duodeno-duodenostomy without any injury of ampulla of Vater. She was recovered uneventfully. During 6 months after operation, she does well without any gastrointestinal symptoms or signs, such as vomiting or constipation.

• Journal of Chest Surgery
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• 제7권2호
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• pp.163-168
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• 1974

Five cases of traumatic diaphragmatic hernia were repaired in the Department of Thoracic Surgery, Seoul National University Hospital, during the period from 1967 to 1974. The first case, a 14-year aid girl, was diagnosed as diaphragmatic hernia during laparotomy because of jejunal perforation 3 days after traffic accident. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture on left posterolateral portion was repaired with two layers of nonabsorbable sutures by transthoracic approach. The second case, a 26-year old man,was diagnosed immediately after traffic accident at a local clinic and transferred to this hospital 24 hours later. Herniated stomach, transverse colon and jejunum were repositioned amd diaphragmatic rupture,about 9 cm in length,from the posterolat.edge to the base of pericardium was sutured in two layers. The third case, a 26-year old man who had stab wound on the left lower lateral chest two years ago,was admitted with sudden abdominal pain and vomiting. Upper gastrointestinal series with barium meal revealed diaphragmatic hernia. The herniated stomach and transverse colon through the defect,about 3.5cm in diameter, at anterolateral portion on the left side,were repositioned and repaired with two layers of nonabsorbable sutures. The forth case, a 26-year old man, sustained blunt trauma to the chest by a roller and was transferred to the emergency room complaining of dyspnea 40 minutes after the accident. The diaphragmatic rupture extended from left midaxillary line to contralateral anterior axillary line,about 20cm long, at anterior portion of diaphragm, which was repaired with two layers, of nonabsorbable sutures. The fifth case, a 4-year old girl, had two separate diaphragmatic ruptures on both sides, which were caused by traffic accident. Immediate upper gastrointestinal series after injury showed herniated stomach, colon and spleen into left Chest cavity. Another small rupture with anterior edge of right lobe of the liver in chest cavity was noted. These were repaired with non-absorbable sutures via thoracotomy.

• 한국방사선학회논문지
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• 제4권3호
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• pp.19-25
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• 2010

연하장애는 뇌졸중 후 환자들에게 일반적으로 발생하지만 동시에 매우 심각한 증상이다. 기도 흡인을 동반한 뇌졸중 환자는 탈수, 영양실조, 폐렴, 폐혈증 심하면 사망에 이를 수 있다. 최근까지도 구개반사와 숨막힘 경험 등이 기도흡인을 결정하는 임상적 지표로 주로 사용되어져 왔다. 이 연구의 목적은 뇌졸중 후 연하장애 환자들을 대상으로 비디오투시 연하검사를 통해 기도흡인을 평가하고 적절한 식이 형태를 선택하는데 있다. 58명의 뇌졸중 환자와 10명의 정상군을 대상으로 하였고 액체, 푸딩, 요플레, 밥 등을 바륨과 혼합하여 투시를 실시하며 먹게하였다. 두명의 재활의학과 의사와 한 명의 방사선사가 위상(구강기, 인두기, 식도기)을 분석하였고, 식도 통과시간을 체크하였다. 인두기는 38명의 환자에서 비정상으로 나타났고, 13명의 환자가 구강기와 인두기에서, 3명의 환자는 구강기에서 2명의 환자는 인두기와 식도기에서 비정상적인 소견을 보였다. 전체 환자중 43명(65.2%)에서 기도흡인을 보였고, 그 중 23명은 턱을 치켜 올리는 자세를 취하여 개선이 관찰되었다. 흡인이 일어난 환자중 34명은 액체타입에서, 2명은 죽타입에서 흡인이 일어났고, 밥에서는 흡인이 없었다. 비디오투시 검사 결과를 통해 비위관을 통해 음식을 섭취하던 23명중 13명이 구강으로 섭취방법을 변경하였으며, 구강 섭취를 하던 43명중 2명은 비위관으로 섭취방법을 변경하였다. 결론적으로 비디오투시 연하조영검사는 뇌졸중 후 연하장애환자의 기도흡인을 평가하는데 매우 유용하다고 할 수 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5023-5029
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• 2013

Background: To evaluate knowledge about screening tests and tests without proven screening value in a Greek Breast Unit population undergoing benign vacuum-assisted breast biopsy (VABB). Materials and Methods: This study included 81 patients. Three knowledge-oriented items (recommended or not, screening frequency, age of onset) were assessed. Regarding screening tests two levels of knowledge were evaluated: i). crude knowledge (CK), i.e. knowledge that the test is recommended and ii). advanced knowledge (AK), i.e. correct response to all three knowledge-oriented items. Solely CK was evaluated for tests without proven screening value. Risk factors for lack of knowledge were assessed with multivariate logistic regression. A second questionnaire was administered 18 months after VABB to assess its impact on the performance of tests. Results: Concerning screening tests considerable lack of AK was noted (mammogram, 60.5%; Pap smear, 59.3%; fecal occult blood testing, 93.8%; sigmoidoscopy, 95.1%). Similarly lack of CK was documented regarding tests without proven screening value (breast self-examination, 92.6%; breast MRI, 60.5%; abdominal ultrasound, 71.6%; barium meal, 48.1%; urine analysis, 90.1%; chest X-Ray, 69.1%; electrocardiogram, 74.1%; cardiac ultrasound, 75.3%). Risk factors for lack of AK were: place of residence (mammogram), age (Pap smear), personal income (sigmoidoscopy); risk factors for lack of CK included number of offspring (breast MRI, chest X-Ray), BMI (abdominal ultrasound), marital status (urine analysis), current smoking status (electrocardiogram). VABB's only effect was improvement in mammogram rates. Conclusions: A considerable lack of knowledge concerning screening tests and misperceptions regarding those without proven value was documented.