• Parasites, Hosts and Diseases
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• v.33 no.2
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• pp.125-130
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• 1995

A 38-year old man visited a private clinic complaining of epigastric discomfort for 2 months A huge hepatic cyst was found by sonography and computerized tomography. An exploratory Laparotomy was performed under the impression of hydatid disease. The cyst was successfully removed. A lot of living protoscolices of Echinocucur Sranulosus were found from the cystic fluid under light microscopy. During the operation, however. the cyst was accidentally ruptured and the cystic fluid spilled out. The patient was medicated with albendazole, and had been well without any signs of anaphylaxis or recurrence for 1 year follow-up period. He had been in Saudi Arabia for 3 years. This is the 16th case of hydatid disease reported in Korea and a case without immediate complication in spite of rupture of the cyst.

• Journal of Chest Surgery
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• v.28 no.11
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• pp.1032-1037
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• 1995

Between September 1988 and December 1993, 32 cases of benign esophageal stricture, of which 12 males and 20 females, were managed in Seoul National University Hospital hospital. Their age ranged from 2 to 61 years, and the mean age was 33.9 years. The ingestion of caustic agent was the most common cause, and the caustic material was acid in 16 patients [58% and alkali in 11patients [39% . Nearly all of the patients complained of dysphagia, and some of chest pain, epigastric pain, weight loss, vomiting, general malaise, and dyspnea. The most frequent site of stricture was found in the upper thoracic esophagus with 34% incidence followed by the lower thoracic esophagus[28% , whole esophagus[19% , and the mid esophagus[16% . The operations performed were 17[53% ECG[esophagocologastrostomy , 5[16% PCG[pharyngocologastrostomy , 5[16% EG[esophagogastrostomy , 2 EJG [esophagojejunogastrostormy by free jejunal graft , and 1 case each of EJ [esophagojejunostomy , esophageal end to end anastomosis, jejunostomy only, and gastrostomy only. In 23 patients [72% , diseased esophaguses were resected, using transhiatal total esophagectomy in 15 [47% and transthoracic partial esophagectomy in 8 [25% . Of those 23 patients, 3 patients [9.4% were diagnosed as esophageal carsinoma on microscopic examination. The postoperative most common complications were unilateral vocal cord palsy in 6 patients [19% , followed by cervical anastomosis leakage in 4 patients [12.5% , wound infection in 2 patients [6% , and pneumothorax in 2 patients [6% . Late death occurred 8 months after the operation in one patient, which was associated with infection due to anastomotic leakage. Our experience shows that the rate of mortality and the morbidity were low in patients receiving surgical management for esophageal stricture and that the cancer transformation rate was high. We recommend esophageal reconstruction surgery with esophagectomy [transhiatal or transthoracic for the esophageal stricture because it can avoid a chance of prevent cancer transformation.

• Archives of Plastic Surgery
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• v.45 no.5
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• pp.441-448
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• 2018

Background Previously, surveys have been used to investigate breast reconstruction statistics. Since 2015, breast reconstruction surgery after mastectomy has been covered by the National Health Insurance Service in Korea, and data from breast reconstruction patients are now available from the Health Insurance Review and Assessment Service (HIRA). We investigated statistics in breast reconstruction in Korea through statistics provided by the HIRA Big Data Hub. Methods We investigated the number of cases in mastectomy and breast reconstruction methods from April 1, 2015 to December 31, 2016. Data were furnished by the HIRA Big Data Hub and accessed remotely online. Results were tabulated using SAS Enterprise version 6.1. Results The 31,155 mastectomy cases included 7,088 breast reconstruction cases. Implant-based methods were used in 4,702 cases, and autologous methods in 2,386. The implant-based reconstructions included 1,896 direct-to-implant and 2,806 tissue-expander (2-stage) breast reconstructions. The 2-stage tissue-expander reconstructions included 1,624 expander insertions (first stage) and 1,182 expander-to-permanent-implant exchanges (second stage). Of the autologous breast reconstructions, 705 involved latissimus dorsi muscle flaps, 498 involved pedicled transverse rectus abdominis myocutaneous (TRAM) flaps, and 1,183 involved free-tissue transfer TRAM flaps, including deep inferior epigastric perforator free-tissue transfer flaps. There were 1,707 nipple-areolar complex reconstructions, including 1,565 nipple reconstructions and 142 areola reconstructions. The 1-year mean number of breast reconstructions was 4,050. Conclusions This was the first attempt to evaluate the total number of breast reconstruction procedures using accurate, comprehensive data, and our findings may prove valuable as a foundation for future statistical studies of breast reconstruction procedures in Korea.

• Parasites, Hosts and Diseases
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• v.22 no.1
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• pp.66-71
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• 1984

Two cases of human infection by adult Spirometra erinacei were proved by collection of worms in Korea. The patients were 24 and 21-year old males residing in a mountainous village in Kangwon-do. They had the clinical complaints of abdominal pain and epigastric discomfort, revealing the diphyllobothriid eggs, $53~59{\times}37-42{\mu}m$ in size, in their stools. They were treated with 500 mg atabrine and purgated with magnesium salts, and 3~4 hours later several chains of tapeworm segments were recovered from the diarrheal stools. The recovered worms revealed the morphological characteristics of spiral-form or coiled uteri, separated vaginal opening from the cirrus sac, incorporated seminal vesicle into the cirrus sac, distribution of testes at the junction between proglottides, asymmetrical eggs with one pointed eggs, etc. and were identified as Spirometra erinacei (Rudolphi, 1819). The cases had the history of eating raw flesh of the snakes and these are considered the source of infection.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.2
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• pp.147-153
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• 2018

Epstein-Barr virus (EBV) infection can be presented with various clinical manifestations and different levels of severity when infected. Infectious mononucleosis, which is most commonly caused by EBV infection in children and adolescents, is a clinical syndrome characterized by fatigue, malaise, fever, sore throat, and generalized lymphadenopathy. But rarely, patients with infectious mononucleosis may present with gastrointestinal symptoms and complicated by gastritis, splenic infarction, and splenic rupture. We encountered a 16-year-old girl who presented with fever, fatigue, and epigastric pain. Splenic infarction and EBV-associated gastritis were diagnosed by using esophagogastroduodenoscopy and abdominal computed tomography. Endoscopy revealed a generalized hyperemic nodular lesion in the stomach, and the biopsy findings were chronic gastritis with erosion and positive in situ hybridization for EBV. As splenic infarction and acute gastritis are rare in infectious mononucleosis and are prone to be overlooked, we must consider these complications when an infectious mononucleosis patient presents with gastrointestinal symptom.

• Parasites, Hosts and Diseases
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• v.22 no.1
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• pp.37-42
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• 1984

Two human cases of Heterophyes heterophyes nocens infection were proved by identifying adult worms after treatment with bithionol or praziquantel in 1983 in Korea. They are 37 (Case 1) and 24-year old (Case 2) males whose resi¬dence or native village is a southern coastal area in Kohiing-gun, Chollanam-do. The Case 1 had the gastrointestinal symptoms such as epigastric pain and indigestion, and the Case 2 heart problems such as arrhythmia and ventricular premature beat in EKG and digestive symptoms such as diarrhea and abdominal pain. After the treatments, 35 and 67 specimens of H. hetero¬phyes nocens respectively were collected from the diarrheal stools through stereomicroscopy. The Case 1 was concommitantly infected with Clonorchis sinensis and the Case 2 with 3 other kinds of heterophyid flukes and with Diphyllo¬bothrium latum. The cases said to have eaten raw brackish water fish such as mullets (Mugil cephalus), perches (Lateolabrax japonicus) and gobies (Acanthogobius flavimanus) which are the intermediate hosts of H. heterophyes nocens in Korea.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.643-647
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• 2006

Purpose: The transverse rectus abdominis myocutaneous(TRAM) flap has become a mainstay of breast reconstruction. The chief disadvantage of the TRAM flap is its potential to create a weakness in the abdominal wall. Nowadays true hernia is less frequent, but bulging that appears at the muscle donor site, or at the contralateral side, or at the epigastric area is still remained as a problem. To prevent this complications, we have used synthetic mesh as well as abdominal muscle plication. Now we report the result of our methods. Methods: We started to use synthetic mesh and muscle plication as supplementary reinforcement for entire abdominal wall, after TRAM flap harvesting, in an attempt to stabilize it and achieve a superior aesthetic result since 2002. We observed complications of TRAM flap donor site, and compared our results (from January, 2002 to January, 2006) with other operator's result (before 2001) at the same hospital in aspect of incidence of abdominal complications. Results: 42 consecutive patients have been performed routine reinforcement with the extended mesh technique and muscle plication from January, 2002 to January, 2006. Mean patient follow up was 25.2 months. No hernia or mesh related infection were encountered and only one patient had a mild abdominal bulging. Nevertheless the our good results, there were no significant statistical differences were observed between two groups. Conclusion: We recommend the using of synthetic mesh and muscle plication for donor site reconstruction after TRAM flap breast reconstruction to improve strength as well as aesthetic quality of the abdominal wall.

• Archives of Plastic Surgery
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• v.33 no.6
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• pp.737-741
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• 2006

Purpose: This study was to evaluate the expression pattern of CD 18(leukocyte adhesion glycoprotein) in ischemia-reperfusion injury of TRAM flap of rats. Through this study, we can obtain more information about ischemia-reperfusion injury. We want to develop specific medicine to improve the survival rate of TRAM flap in the future. Methods: A TRAM flap supplied by a single pedicle superior epigastric artery and vein was elevated on 60 Sprauge-Dawley rats. The rats were divide into 6 groups (each group n=10); Group O: sham, no ischemia-reperfusion injury, Group I: 2 hour reperfusion after 4 hour ischemia, Group II: 4 hour reperfusion after 4 hour ischemia, Group III: 8 hour reperfusion after 4 hour ischemia, Group IV: 12 hour reperfusion after 4 hour ischemia, and Group V: 24 hour reperfusion after 4 hour ischemia. This study consisted of gross examination for flap survival and flow cytometry study of CD18 on neutrophils. Results: The gross measurement of the flap showed different survival rate in group I(71%), II(68%), III(37%), IV(34%) and V(34%). All experimental groups showed an increase in the expression of CD18 compared to group O. The expression of CD18 was rapidly increased in ascending order in group I, II and III. But, the expression of CD18 was maintained in group IV and V. Conclusion: The results can be implemented in the study to develop drugs which are capable of reducing ischemia-reperfusion injury in microsurgical breast reconstruction.

• Journal of Yeungnam Medical Science
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• v.33 no.1
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• pp.33-36
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• 2016

Metformin, commonly prescribed for type 2 diabetes, is considered safe with minimal side-effect. Acute pancreatitis is rare but potentially fatal adverse side-effect of metformin. We report a patient on hemodialysis with metformin-related acute pancreatitis and lactic acidosis. A 62-year-old woman with diabetic nephropathy and hypertension presented with nausea and vomiting for a few weeks, followed by epigastric pain. At home, the therapy of 500 mg/day metformin and 50 mg/day sitagliptin was continued, despite symptoms. Laboratory investigations showed metabolic acidosis with high levels of lactate, amylase at 520 U/L (range, 30-110 U/L), and lipase at 1,250 U/L (range, 23-300 U/L). Acute pancreatitis was confirmed by computed tomography. No recognized cause of acute pancreatitis was identified. Metformin was discontinued. Treatment with insulin and intravenous fluids resulted in normalized amylase, lipase, and lactate. When she was re-exposed to sitagliptin, no symptoms were reported.

• Journal of Chest Surgery
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• v.29 no.3
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• pp.311-314
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• 1996

Eighteen patients (13 female and ave male) aged from 15 to 62 years (mean age 42.6 years) underwent excision of cardiac myxoma(17 left atrial, one right atrial) between 1985 and 1994 at Pusan National University hospital. All patients complained of exertional dyspnea and most had a few additional symtoms including palpitation, chest pain, syncope, general weakness, weight loss, fever, cough and epigastric disconyort. The diagnosis was made by echocardiography alone in left atrial myxomas but a myxoma in right atrium was diagnosed incidentally during mitral valve replacement for rheumatic valvular heart disease. The tumor attachment sites were fossa ovalis in 13, other interatrial septum in 4, mitral valve annulus in one and free wall of left atrium in two cases. The tumor was excised successfully via right atriotomy in 8 and biatriotomy in 10 cases. There was no hospital nor late death, and no recurrent case during the follow up period. Curative surgical excision of cardiac myxoma can be performed with low morbidity and very low r currence rate.