• Journal of Gastric Cancer
• /
• v.13 no.1
• /
• pp.65-68
• /
• 2013

Gastric carcinoma rarely presents as a perforation, but when it does, is perceived as advanced disease. The majority of such perforations are Stage III/IV disease. A T1 gastric carcinoma has never been reported to perforate spontaneously in English literature. We present a 56 year-old Chinese male who presented with a perforated gastric ulcer. Intra-operatively, there was no suspicion of malignancy. At operation, an open omental patch repair was performed. Post-operative endoscopy revealed a macroscopic Type 0~III tumour and from the ulcer edge biopsy was reported as adenocarcinoma. Subsequently, the patient underwent open subtotal gastrectomy and formal D2 lymphadenectomy. The final histopathology report confirms T1b N0 disease. The occurrence of a perforated early gastric cancer reemphasises the need for vigilance, including intra-operative frozen section and/or biopsy, as well as routine post-operative endoscopy for all patients.

• Journal of Korean Neurosurgical Society
• /
• v.47 no.5
• /
• pp.392-394
• /
• 2010

Trochlear nerve palsy associated with spontaneous subarachnoid hemorrhage (SAH) is known to be a rare malady. We report here on a patient who suffered with left trochlear nerve palsy following rupture of a right posterior communicating artery aneurysm. A 56-year-woman visited our emergency department with stuporous mental change. Her Hunt-and-Hess grade was 3 and the Fisher grade was 4. Cerebral angiography revealed a ruptured aneurysm of the right posterior communicating artery. The aneurysm was clipped via a right pterional approach on the day of admission. The patient complained of diplopia when she gazed to the left side, and the ophthalmologist found limited left inferolateral side gazing due to left superior oblique muscle palsy on day 3. Elevated intracranial pressure, intraventricular hemorrhage or a dense clot in the basal cisterns might have caused this trochlear nerve palsy.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.12 no.1
• /
• pp.51-56
• /
• 2009

We report a rare case of gastric perforation in a 13-year-old boy with anorexia nervosa. He was admitted to our hospital with the chief complaint of body weight loss. He had lower abdominal pain after 2 days. An abdominal CT revealed diffuse peritonitis. At laparotomy, the stomach was dilated and perforated. Postoperatively, the patient suffered from malnutrition. We monitored electrolytes, minerals, and fluids closely before and during the initiation of feedings to prevent morbidity and mortality associated with refeeding syndrome. We present an extremely rare complication that relates to this phenomenon, describing an acute gastric dilatation that led to gastric necrosis and perforation through an unusual mechanism in an extremely anorectic teenager during hospitalization for refeeding.

• Journal of Chest Surgery
• /
• v.49 no.6
• /
• pp.478-480
• /
• 2016

Spontaneous perforation of the esophagus after forceful vomiting is known as Boerhaave syndrome, a rare and life-threatening condition associated with a high rate of mortality. The management of Boerhaave syndrome is challenging, especially when diagnosed late. Herein, we report the successful management of late-diagnosed Boerhaave syndrome with T-tube drainage in a 55-year-old man. The patient was transferred to our institution 8 days after the onset of symptoms, successfully managed by placing a T-tube, and was discharged on postoperative day 46 without complications.

• Journal of Korean Neurosurgical Society
• /
• v.42 no.3
• /
• pp.173-178
• /
• 2007

Objective : Hydrocephalus is one of the major complications following spontaneous subarachnoid hemorrhage (SAH). However, the risk factors of the hydrocephalus after SAH are not still well known. This study was focused on verification of the causal relationships between the development of hydrocephalus and SAH. Methods : The patients who developed hydrocephalus after rupture of aneurysms were studied. To obtain prognostic factors regarding to hydrocephalus, several parameters such as age, sex, hypertension, location of aneurysm, existence of intraventricular hemorrhage (IVH) and intracerebral hemorrhage (ICH), Glasgow coma scale (GCS), Hunt-Hess SAH classification & Fisher Grade on admission and the ratio of frontal harn of lateral ventricle diameter to skull inner table diameter at this level (FH/ID) were studied retrospectively. Results : The development of hydrocephalus following SAH is multifactorial. The age, IVH, FH/ID ratio were related to hydrocephalus in analysis. There is a low clinical correlation between sex, hypertension, location of aneurysm, existence of ICH, GCS, Hunt-Hess SAH classification, Fisher Grade on admission and hydrocephalus. Conclusion : Knowledge on risk factors related to the occurrence of hydrocephalus may help guide neurosurgeons in the long-term care of patients who have experienced aneurysmal SAH.

• Journal of Korean Neurosurgical Society
• /
• v.50 no.5
• /
• pp.457-459
• /
• 2011

A rare case of spontaneous subarachnoid hemorrhage from newly developed cerebral aneurysm in glioblastoma patient is presented. A 57-year-old man was presented with headache and memory impairment. On the magnetic resonance image and the magnetic resonance angiography, a large enhancing mass was found at right frontal subcortex and intracranial aneurysm was not found. The mass was removed subtotally and revealed as glioblastoma. He took concurrent PCV chemotherapy and radiation therapy, but the mass recurred one month later after radiotherapy. He was then treated with temozolomide for 7 cycles. Three months after the completion of temozolomide therapy, he suffered from a subarachnoid hemorrhage due to a rupture of a small de novo aneurysm at distal anterior cerebral artery. He underwent an aneurysm clipping and discharged without neurologic complication.

• Journal of Chest Surgery
• /
• v.25 no.1
• /
• pp.96-104
• /
• 1992

The 242 patients were operated due to chronic empyema in Hanyang University Hospital From Jan, 1983 to Aug, 1991, we operated 17 patients by modified.Schede`s thoracoplasty with myoplasty and we concluded to next scentences. 1. The age of patients were varied from 28 to 65[Average 39.1] and male preponderance was seen[more than 3 times]. 2. The preoperative cause of disease were tuberculosis in 14 patients[3 patients were associated with aspergillosis, and 1 patient was associated vrith actinomycosis], lung abscess in 2 patients, and haemophilia in 1 patient. 3. The Preoperative duration of empyema were varied from 1 month to 30 years[Average 49.8 month], and the duration from pulmonary resection to thoracoplasty were 1 month to 13.5 years[Average 55 month] except 3 patients, who were operated pneunectomy with thoracoplasty at the same time. 4. The total number of thoracoplasty were 19, because in 2 patients, we operated 2 steps, and we failed in 6 cases, so the success rate was 68.5%. 5. In failure analysis of 6 cases, the cause were obliteration failure in 3 cases, inadequete drainage in 1 case, and in the other 1 case was mixed type. 6. From 1990 to 1991, there were no death associated with operation and there were 1 failure, so the success rate was greatly improved. 7. The bronchopleural fistula or spontaneous rupture of trachea were seen in 12 cases, and the success rate was high in absent cases.

• Journal of Yeungnam Medical Science
• /
• v.2 no.1
• /
• pp.299-306
• /
• 1985

Congenital dilatation of the common bile duct is relatively rare anomaly. Its pathogenesis has not been completely understood. Complications of the choledochal cyst are mainly suppurative cholangitis, liver cirrhosis, stone formation, malignant change, bile peritonitis due to spontaneous and traumatic rupture. We experienced one case of choledochal cyst associated with hemorrhagic tendency and a cerebral hematoma, which is extremely rare complication. The 3 monthes old male patient reported here was treated with complete excision of cyst and Roux-en-Y choledochojejunostomy after correction of bleeding tendency and removal of crebral hematoma. Postoperative course was relatively uneventful, 11 days after operation, the patient was discharged with full improvement.

• The Journal of Korean Physical Therapy
• /
• v.34 no.6
• /
• pp.326-331
• /
• 2022

Purpose: The stroke patients have gait dysfunction due to impaired neural tracts; corticospinal tract (CST), corticoreticular pathway (CRP), and vestibulospinal tract (VST). In this study, we investigated characteristics of gait pattern according to the injury aspect of the neural track in a stroke patient. Methods: One patient and six control subjects of similar age participated. A 19-year-old male patient with spontaneous intracerebral hemorrhage on right basal ganglia, thalamus, corona radiata and cerebral cortex due to arteriovenous malformation rupture. Diffusion tensor imaging (DTI) data was acquired 21 months after the stroke. Kinematic and spatio-temporal parameters of gait were collected using a three-dimensional gait analysis system. Results: On 21 months DTI, the CST and CRP in affected hemisphere showed severe injury, in contrast, the VST in affected hemisphere showed intact integrity. Result of gait analysis, walking distance and speed were significantly decreased in a patient. The stance rate of unaffected lower limb, the swing rate of affected lower limb and the duration of double stance significantly increased compared with normal control. The knee and hip joint angle were significantly decreased in a patient. Conclusion: We found recovered independent gait ability may be associated with unimpaired VST in a patient with severe injury in CST and CRP.

• Journal of Chest Surgery
• /
• v.40 no.2 s.271
• /
• pp.122-127
• /
• 2007

Background: Spontaneous pneumothorax is a common respiratory condition and has been postulated that it develops because of rupture of subpleural blebs. Although the morphology and ultrastructure of causative lesions are well known, the reason for rupture of sbupleural blebs is not absolutely clear. Broad consensus concerning the role of meteorological factors in spontaneous pneumothorax dose not exist. The aim of the study was to examine the influence of change of atmospheric pressure and temperature on the occurrence of spontaneous pneumothorax. Material and Method: One hundred twenty eight consecutive spontaneous pnemothorax events that occurred between January 2003 and December 2004 were selected. Changes of meteorological factors of particular days from the day before for 5 consecutive days were calculated and compared between the days with pneumothorax occurrence (SP days) and the days without pneumothorax occurrence (Non SP days). The correation between change of pressure and temperature and the occurrence of SP was evaluated. Result: SP occurred on 117 days (16.0%) in the 2-year period. Although there was no significant differences in change of pressure factors prior 4 days of SP occurrence compare to the 4 days prior Non SP day, change of mean pressure was higher (+0.934 vs. -0.191hPa, RR 1.042, Cl $1.003{\sim}1.082$, p=0.033), and change of maximum pressure fall was lower (3.280 vs. 4.791 hPa, RR 1.051, Cl $1.013{\sim}l.090$, p=0.009) on the 4 days prior SP day. There were significant differences in change of temperature factors prior 2 days and the day of SP, Changes of mean temperature (-0.576 vs.+$0.099^{\circ}C$, RR 0.886, 95% Cl $0.817{\sim}0.962$, p=0.004) and maximum temperature rise (7.231 vs. $8.079^{\circ}C$, RR 0.943 Cl $0.896{\sim}0.993$, p=0.027) were lower on the 2 days prior SP. But changes of mean temperature (0.533 vs. $-0.103^{\circ}C$, RR 1.141, Cl $1.038{\sim}l.255$, p=0.006) and maximum temperature rise (9.209 vs. $7.754^{\circ}C$, RR 1.123, Cl $1.061{\sim}1.190$, p=0.006) and maximum temperature rise (9.209 vs. $7.754^{\circ}C$ RR 1.123, Cl $1.061{\sim}l.190$, p=0.000) were higher on the SP days. Conclusion: Charge of atmospheric pressure and temperature seems to influence the chance of occurrence of SP. Meteorological phenomena that pressure rise 4 day prior to SP and following temperature fall and rise might explain the occurrence of SP. Further studies should be continued in the future.