• Clinical and Experimental Pediatrics
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• 제46권9호
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• pp.921-925
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• 2003

저자들은 얼굴 부종, 복부 팽만 및 저알부민혈증을 주소로 내원한 8세 환아에서 원발성 장림프관 확장증으로 진단된 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제46권12호
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• pp.1279-1282
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• 2003

저자들은 산전 초음파에서 복부 종괴가 발견되어 관찰 도중 복부 팽만과 호흡 부전이 발생하여 방사선요법과 항암요법으로 치료하였던 양측성 선천성 신경모세포종 1례를 문헌 고찰과 함께 보고하는 바이다. 선천성 양측성 신경모세포종의 경우 임상경과를 잘 관찰하고 치료여부를 결정하여야 할 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제58권8호
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• pp.288-293
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• 2015

Purpose: In this study, we aimed to review the clinical presentation of preterm infants with gastrointestinal perforations and compare the clinical features of gastric perforation with other intestinal perforations. Methods: The medical records of preterm neonates with pneumoperitoneum, admitted to the neonatal intensive care unit (NICU) between January 1994 and December 2013, were retrospectively reviewed. Results: Twenty-one preterm infants underwent exploratory laparotomy to investigate the cause of the pneumoperitoneum. The sample consisted of five patients (23.8%) with gastric perforation and 16 patients (76.2%) with intestinal perforation. No statistical differences were found in the birth history and other perinatal factors between the two groups. Underlying necrotizing enterocolitis, bilious vomiting, and paralytic ileus preceding the perforation were statistically more common in the intestinal perforation group. All preterm infants with gastric perforation survived to discharge; however, six preterm infants with intestinal perforation expired during treatment in the NICU. In the gastric perforation group, sudden pneumoperitoneum was the most common finding, and the mean age at diagnosis was $4.4{\pm}1.7days$ of life. The location and size of the perforations varied, and simple closure or partial gastrectomy was performed. Conclusion: Patients with gastric perforation did not have a common clinical finding preceding the perforation diagnosis. Although mortality in previous studies was high, all patients survived to discharge in the present study. When a preterm infant aged less than one week presents with sudden abdominal distension and pneumoperitoneum, gastric perforation should first be excluded. Prompt exploratory laparotomy will increase the survival rates of these infants.

• 한국임상수의학회지
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• 제25권4호
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• pp.314-316
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• 2008

급성 위확장은 실험시설에서 사육되고 있는 Macaca 원숭이에서 가장 흔하게 발생하는 응급상황 중에 하나이다. 이 보고서는 사육 원숭이에서 발생한 몇몇 증례를 소개하고자 한다. 급성 위확장증을 보인 원숭이들에는 실험을 위해 원숭이 보정의자에 앉힌 경우나 마취를 한 경우, 그리고 아무런 처치도 하지 않은 경우 등이 있었다. 이환된 동물들은 심한 복부팽만, 탈수, 청색증과 호흡곤란 등을 동반한 혼수 상태를 보였다. 한 증례는 전신장애로 인해 상태가 악화되고 폐사하여 부검을 실시하였다. 나머지 두 증례는 위관과 수액요법으로 응급처치를 한 결과 병증에서 회복되었다. 부검결과, 위의 대부분은 위내 가스와 물 그리고 섭취물로 채워져 있었다. 이 보고서는 영장류에서 급성위확장증의 발생과 관리에 대한 특별한 강조와 더불어 본 질환이 비 특이적인 원인에 의해 발생할 수 도 있음을 시사한다.

• 한국동물위생학회지
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• 제32권3호
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• pp.189-200
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• 2009

The purpose of this study was to evaluate the effect of a subsequent infection of PCV2 on piglets with PEDV. In clinical signs, the signs observed in dual-infected with PEDV and PCV2 piglets and alone infected with PEDV piglets ranged from diarrhoea to vomiting and dehydration. Dual-infected piglets developed signs of anorexia, vomiting and watery diarrhoea within 12 hpi. Nevertheless alone -infected piglets caused pasty diarrhea at first. In mortality, dual infections showed 25%, but alone -infections showed 8.3%, respectively. In gross findings, piglets dual-infected with PEDV and PCV2 appeared the severe findings of congestion, distension of lumen, milder curdes of undigested milk in stomach than those of single-infected piglets. In histopathological findings, piglets of dual-infection group appeared the more severe findings of villous atrophy and fusion, congesion, exfoliation, vacuolation, squamation, loss of cilia and proliferation of crypt. Significant (P<0.05) decrease in VH:CD ratio in dually infected piglets compared to piglets from alone-PEDV infections. In immunohistochemical findings, strong hybridization signals in dual-infected piglets observed moderate to severe villous atrophy or vacuolation with positive cells arranged continuously over the villi. In the lumen, exfoliated enterocytes were strongly positive in dual-infected piglets. A number of PEDV-positive cells in dual-infected pigs were significantly higher than that in alone PEDV-infected piglets.

• 한국동물위생학회지
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• 제40권4호
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• pp.287-292
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• 2017

A five-year-old, male, Great Dane weighing 107 kg was presented with anorexia, abdominal distension, and dyspnea for 5 days. Physical examination, blood works, radiography, electrocardiography (ECG), and echocardiography were performed. Based on severely low fractional shortening (FS) and marked four chamber enlargement in echocardiography, continuous atrial fibrillation and occasional ventricular premature complex (VPC) on ECG, the dog was diagnosed as dilated cardiomyopathy (DCM) concurrent with congestive heart failure. Pleural effusion and ascites were modified transudate. In accordance with DCM scoring system recommended by European Society of Veterinary Cardiology (ESVC), DCM score was 13/15 in this case. Concentrations of cTnI and NT-pro-BNP were 1.0 ng/mL and 693 pmol/L, respectively. Since the former and the latter were remarkably high values, it was certain that the patient had grave prognosis. Intensive care was performed for the dog and the clinical signs as well as the radiographic abnormalities were resolved. However, when he presented serious dyspnea again at 25 days post therapy, the dog was dead. In case of canine DCM, the scoring system for the diagnosis and cardiac biomarkers including NT-pro-BNP and cTnI could be useful to advise owners on the status and prognosis of their dog with DCM.

• Asian Pacific Journal of Cancer Prevention
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• 제16권11호
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• pp.4787-4790
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• 2015

Objective: To review ovarian cancer cases in children and adolescents in Siriraj Hospital and assess the prognosis, recurrence of disease, and reproductive outcomes after treatment. Materials and Methods: A retrospective descriptive study was conducted in ovarian cancer patients 21 years and younger who had been treated at Siriraj Hospital between January 1990 and December 2009. Medical records were reviewed and relevant data were recorded. Results: A total of 48 cases met the criteria; their mean age was 16.4 years. Abdominal distension was the major symptom. 91.6% were germ cell tumors and the remaining cases were sex cord-stromal and epithelial tumors. More than half (25/48 cases) presented with stage I disease. The most common used chemotherapy regimen for germ cell tumors was BEP (bloemycin, etoposide, cisplatin). Most of patients had favorable outcomes; 46/48 cases had complete remission and retained their good health at the time of the review. We had only one recurrent case and one dead case. Ten of contacted patients had married and 3 of them had successful full-term pregnancies. Conclusions: Ovarian malignancy in children and adolescents is a rare disease. The authors reported 48 cases in 20 year-period of work. Most of them have favorable outcomes. Return of ovarian function and fertility are the topics of interest.

• Advances in pediatric surgery
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• 제13권1호
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• pp.61-65
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• 2007

Conventional treatment of Hirschsprung's disease consists of initial colostomy followed by pull-through operation. But, the treatment of Hirschsprung's disease has been changed along with the development of new surgical technique. Since 1995, endo-GIA has been available at our hospital and one stage Duhamel operation has been performed for neonatal Hirschsprung's disease. Between May 1995 and April 2006, 26 neonates have been treated with one stage pull-through operation by one pediatric surgeon at HanYang University Hospital. The sex ratio was 4.2:1 with male predominance. Clinical findings included abdominal distension (96.2 %), vomiting (50.0 %), delayed passage of meconium (46.2 %), constipation (23.1 %), and enterocolitis (15.4 %). Twenty two cases (84.6 %) were short-segment and 4 cases (15.4 %) were long-segment disease, of which 2 cases were total colon aganglionosis. One of the two patients with total colonic aganglionosis had double transition zones - distal ileum and hepatic flexure of the colon. The average age at operation was $14.56{\pm}8.77$ days and the average weight at operation was $3.26{\pm}0.66kg$. Primary Duhamel operations were performed in 25 patients and Soave-Boley operations was performed in one patient. The endo-GIA 35 (Ethicon, USA) was used from 1995 until 1997, and after that endo-GIA 60 (USSC, USA) was used. The average Duhamel operation time was $88.57{\pm}22.80$ minutes. Wound abscess (n = 2) and septum formation (n =1) occurred after Duhamel operation. Bowel function was normalized in 59 % within 3 months and in 95% within 1 year after operation. There was no mortality after one stage pull-through operation in neonate.

• Advances in pediatric surgery
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• 제13권1호
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• pp.13-22
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• 2007

Fundoplication is accepted as an effective treatment of gastroesophageal reflux disease. The recent results of laparoscopic fundoplication demonstrated safety and less morbidity, shorter hospital stay and less pulmonary complication compared to the open operation. Laparoscopic fundoplication has been our first choice of operation for gastroesophageal reflux disease since 2003. Among 29 cases, there were 2 conversion cases because of severe distension of transverse colon and hepatomegaly. We studied 27 consecutive patients operated upon from January 2003 through December 2004. There were 15 boys and 12 girls, ages from 1.5 months to 12 years (median 25.3 months). Body weight ranged from 2.9 kg to 37 kg (median 9.8 kg). Neurological abnormalities were present in 23 patients. Indications for surgery included medically refractory reflux associated with vomiting, pneumopathy, otorhinolaryngologic pathology, failure to thrive, esophagitis, apnea and bradycardia. We used 4-5 trocars of 5 mm or 12 mm with $30^{\circ}$ telescope and performed the Nissen technique in all patients. In neurological impaired patients, gastrostomy tube was placed at the time of fundoplication. Median operative time was 130 minutes (70 - 300 minutes). There was no mortality nor intraoperative complication. Twenty-six patients were followed for median of 19 months (8 - 31 months). Four patients (15.4 %), who were all neurological impaired, developed recurrent symptoms of gastroesophageal reflux disease. Two of these patients had reoperation (1 laparoscopic approach, 1 open method). There were significant increases in body weight in 11 patients after fundoplication. Laparoscopic fundoplication is acceptable as a safe and effective method for gastroesophageal reflux disease.

• Advances in pediatric surgery
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• 제7권1호
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• pp.31-36
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• 2001

Mesenchymal hamartoma of the liver is a rare benign tumor, usually presenting in early childhood, Five children with mesenchymal hamartoma of the liver pathologically verified at Seoul National University Children's Hospital between 1978 and 2000 were analyzed retrospectively. There were two girls and three boys, and their mean age at the operation was 16.0months (range, 4-32 months). Three patients presented with abdominal distension. A patient was detected incidentally, and another was detected by prenatal ultrasongraphic examination. Tumor size ranged from $10{\times}8.5cm$ to $34{\times}29cm$. Three tumors were located in the right lobe and two in the left lobe. Four cases underwent complete surgical resection, and the other one underwent incomplete surgical resection and marsupialization. Recurrence or malignant transformation was not noted. Five patients survived without evidence of disease for 35, 36, 38, 142 and 228 months. In conclusion, although mesenchymal hamartoma of the liver is benign lesion. it may be confused. and mixed with embryonal sarcoma. A recent report showed recurrence or malignant transformation after partial excision of the tumor. Therefore. complete excision of the tumor with surrounding normal liver tissue is recommended.