• 제목/요약/키워드: abdominal adhesion

검색결과 51건 처리시간 0.024초

비외상성 기흉의 임상적 고찰 (Nontraumatic Pneumothorax -A Review of 56 Cases-)

  • 곽문섭
    • Journal of Chest Surgery
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    • 제2권2호
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    • pp.133-140
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    • 1969
  • We observed 56 cases of nontraumatic pneumothorax clinically and statistically, which had been experienced at the deparment of chest surgery. St. Mary`s Hospital,Catholic Medical College in theserecent years. 1] In the underlying pathology of spontaneous pneumothorax, nontuberculous origin [60.7%], especially due to pulmonary emphysema or blebs[17.8%], especially due to pulmonary emphysema or blebs[17. 8%], tended to increase as the reports of foreign countries, but tuberculous origin was still high in our country[39.3%]. Considering the 14 cases, unknown underlying pathology, the most of them might have scattered blebs which were not revealed in chest Roentgen films. 2] The principle treatment done in our clinic was as follows; The patients, below 20% lung collapse were treated by bed rest and abdominal respiration. The patients, between 20% and 40% lung collapse were treated by repeated pleural aspiration or closed thoracotomy followed. The cases,over 40% lung collapse were treated by closed thoracotomy initially. 3] The average duration of indweIling catheter was 3 to 4 days in the closed thoracotomy. We used to not remove the indwelling catheter early to promote pleural adhesion. 4] Sometimes, the closed thoracotomy drainage induces bronchial irritation and asthmatic attacks, especially in old age group accompanying pulmonary emphysema. In these cases, respiratory difficulties and acidosis should be prevented and controlled with medical treatment including steroid therapy.

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Contained Gallbladder Rupture in Two Dogs with Small-Sized Gallbladder

  • Chang-Hwan Moon;Hee-Jin Kim;Won-Jong Lee;Young-Sam Kwon;Jae-Min Jeong;Dae-Hyun Kim;Hae-Beom Lee;Seong Mok Jeong
    • 한국임상수의학회지
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    • 제40권6호
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    • pp.452-456
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    • 2023
  • This report presents two rare cases of gallbladder rupture in dogs with small gallbladders that did not result in bile leakage and their subsequent surgical treatment. The report includes a 5-year-old spayed female Chihuahua weighing 3.5 kg and a 9-year-old castrated male Poodle weighing 5.3 kg. Both dogs had elevated liver enzyme levels on blood chemistry. However, only the second dog (2) (Poodle) presented with hyperbilirubinemia and jaundice, whereas the first dog (Chihuahua (1)) did not display any specific clinical signs. Diagnostic imaging revealed a small gallbladder in both dogs, and the dogs were diagnosed with cholecystolithiasis (1) and extrahepatic biliary tract obstruction (2). No bile leakage-related abdominal effusion was observed. Gallbladder rupture and adhesion to the adjacent tissues were confirmed during cholecystectomy.

중간엽줄기세포와 생분해성 매트릭스를 이용한 혈관 패치 개발

  • 조승우;김동익;박희정;최차용;김병수
    • 한국생물공학회:학술대회논문집
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    • 한국생물공학회 2003년도 생물공학의 동향(XII)
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    • pp.98-100
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    • 2003
  • 합성고분자(PET, ePTFE)로 제작된 기존의 혈관 패치는 혈전생성으로 인한 혈관 막힘 현상과 생체 비적합성으로 인한 석회화 현상 때문에 장기간 혈관 기능을 수행할 수 없다. 본 연구에서는 혈관조직을 형성하는 세포들로 분화가 가능한 중간엽줄기세포와 생체적합성 매트릭스를 이용하여 혈관용 패치를 개발하였다. 이식 후 3주에 관찰하였을 때 조직공학적으로 제조된 혈관 패치는 동물 임상시험에서 혈관막힘 현상 없이 혈관기능을 수행하였고 실제 혈관과 유사한 조직으로 재생되었다. 동물모델에서의 장기간 추가 보완 연구를 거친다면 본 연구에서 개발된 혈관 패치는 기존의 재료를 대체하여 많은 혈관질환 치료에 적용이 가능할 것으로 사료된다.

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소아의 유착성 장폐쇄증에 대한 임상적 고찰 (Clinical Analysis of Adhesive Ileus in Children)

  • 이종재;윤현조;정연준;김재천
    • Advances in pediatric surgery
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    • 제7권2호
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    • pp.118-125
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    • 2001
  • The effectiveness of operative and non-operative management for postoperative adhesive ileus in children has been discussed. This study reviews the clinical characteristics and the treatment consequences of adhesive ileus in our institution. Department of Surgery of Chunbuk National University Hospital, retrospectively. A total of 62 cases of post-operative small bowel obstruction treated between January 1975 and December 1998 under the 15 years of age are included in this study. The patients were divided into two groups, operative(n=26) and non-operative(n=36) groups. The prevalent age was between 11 and 15 years(28 cases; 45.2 %), and the most common previous operation was appendectomy(28 cases; 45.2 %). The most common operative procedures were adhesiolysis(17 cases; 65.4 %). The interval between admission and operation was 1 day in 11 cases(42.3 %). The most common site of adhesion was the ileum in 13 cases(50.0 %) and band constriction was the most frequent pattern(8 cases; 30.8 %). Intestinal resection was significantly high in delayed operations of more than four days, in the patients with three or more classical signs of strangulation(fever, tachycardia, leukocytosis, abdominal pain, rebound tenderness), and in the cases of complete obstruction on plain abdomen film(p < 0.05). In conclusion, operation should be considered in cases with three or more signs of strangulation, no clinical improvement for over four days of conservative treatment, and signs of complete obstruction on plain abdomen film during the observation periods.

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신생아에서 급성 복증으로 발현된 Meckel 게실 1예 (A Case of Meckel's Diverticulum Presented with Acute Abdomen in a Newborn)

  • 임재영;장선화;조재민;고경혁;박은실;서지현;박찬후;우향옥;윤희상
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제8권2호
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    • pp.222-225
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    • 2005
  • 출생 후 건강하게 지내던 중 생후 9일째 급성 복증 및 장 폐쇄의 증상으로 내원한 남아에서 시험적 개복술 시행하여, Meckel 게실 천공과 장 유착을 발견하고 수술적으로 제거한 후 회복된 증례이다. 병리 소견상 경한 게실 염과 정상 장 점막 소견을 보여 자발적 Meckel 게실 천공이라고 추정 되는 증례이다. 신생아시기에 자발적 Meckel 게실 천공은 매우 드물지만 심각한 질환이다. 따라서 신생아 시기에 급성 복증 증상을 보일 때 반드시 감별 진단 목록에 Meckel 게실을 포함시켜야만 한다.

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Anti-aging Effect and Gene Expression Profiling of Aged Rats Treated with G. bimaculatus Extract

  • Ahn, Mi Young;Hwang, Jae Sam;Yun, Eun Young;Kim, Min-Ji;Park, Kun-Koo
    • Toxicological Research
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    • 제31권2호
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    • pp.173-180
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    • 2015
  • Extract from Gryllus bimaculatus crickets inhibits oxidation at the DNA level, with reduced production of 8-hydroxy-2'-deoxyguanosine (8-OHdG). Microarray analyses were performed with a rat 28K cDNA clone set array to identify the gene expression profiles of aged (10 months old) Wistar Kyoto rats treated for one month with 100 mg/kg G. bimaculatus ethanol extract to assess the effects. The extract produced a meaningful anti-edema effect, evident by the inhibition of creatinine phosphokinase activity. The weights of abdominal and ovarian adipose tissues were reduced and the proportion of unsaturated fatty acids in adipose tissues was increased in an extract dose-dependent manner. Compared with untreated control rats, rats treated with the extract displayed the upregulation of 1053 genes including Fas (tumor necrosis factor receptor superfamily, member 6), Amigo3 (adhesion molecule with an immunoglobulin-like domain), Reticulon 4, 3-hydroxy-3-methylglutaryl-coenzyme (Hmgcr; a reductase), related anti-fatigue (enzyme metabolism), and Rtn antioxidant, and the downregulation of 73 genes including Ugt2b (UDP glycosyltransferase 2 family), Early growth response 1, and Glycoprotein m6a. Data suggest that G. bimaculatus extract may have value in lessening the effects of aging, resulting in a differential gene expression pattern indicative of a marked stress response and lower expression of metabolic and biosynthetic genes.

말의 그물막구멍포착 교정을 위한 소장 절제 및 문합 1례 (Small Intestine Resection and Anastomosis for Epiploic Foramen Entrapment of a Horse)

  • 황혜신;박철규;황준석;천용우;;이인형
    • 한국임상수의학회지
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    • 제32권4호
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    • pp.374-379
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    • 2015
  • A 10-year-old gelding Warmblood weighing 560 kg was referred to J&C Equine Hospital with the history of hyperpnea, depression, pawing, and rolling for 7 hours. According to the results of clinical and ultrasound examination, it was considered that intestines were distended with thickened wall. The horse had been treated with lactated Ringers' solution (14 L, IV), flunixin meglumine (1.1 mg/kg, IV), and mineral oil (1 L, PO), but he did not show any responses to those treatments. Exploratory laparotomy was performed and identified incarcerated small intestine through the epiploic foramen. The horse received resection and anastomosis of the entrapped small intestine. After surgery, the horse was treated with intensive postoperative care of fluid therapy (5 L with 20 mEq/L KCl, every 2 hours), flunixin meglumine (1.1 mg/kg, IV, sid), antibiotics (penicillin 22,000 IU/kg, IV, qid and gentamicin 6.6 mg/kg, IV, sid), lidocaine constant rate infusion (bolus 1.3 mg/kg over 15 minutes then 0.05 mg/kg/minute), common nutritional supplements, nasogastric intubation every 2 hours and trunk bandage. Postoperative feeding program had started with small amount of hay every 4 hours and gradually increased to normal amount till 5 days. At 77 days after surgery, he showed sudden outbreak of colic and was euthanized. The causes of colic were small intestinal strangulation by passing through the mesenteric rents and postoperative adhesion between small intestines. According to the results, it is recommended to perform perioperative intensive care of horse with colic and to use several methods to prevent adhesions during abdominal surgery of horses.

The Effects of Hyaluronic Acid-Carboxymethylcellulose Membrane (GUARDIX-$MB^{(R)}$) Barriers on Prevention of Post-operation Peritoneal Adhesions in Dogs

  • Lee, Sang-Mook;Jang, Hwan-Soo;Bae, Jae-Sung;Kim, Jung-Eun;Jang, Kwang-Ho
    • 한국임상수의학회지
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    • 제25권6호
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    • pp.494-500
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    • 2008
  • The aim of this study was to determine the effectiveness of hyaluronic acid-carboxymethylcellulose membrane (GUARDIX-$MB^{(R)}$) barriers on prevention against post-operative peritoneal adhesions. In this study, fourteen mongrel dogs were divided into two experimental groups: 0.1 % hyaluronic acid (0.1HA) group and hyaluronic acidcarboxymethylcellulose membrane (HA-CMC) group. In order to induce adhesions, the anti-mesenteric serosa of the ileum was exteriorized and then abraded in a standard manner by scraping with a scalpel blade to create homogenous petechial hemorrhagic surface over a $1\;{\times}\;1cm$ area. Solution of 0.1HA were simply coated over the abraded tissues, $1.5\;{\times}\;1.5cm$ HA-CMC membrane was placed over the abraded tissues, allowed to spread across the intra-abdominal organs before closure of the abdomen. On day 1 before and day 1, 4, 7, 14, and 21 after operation, venous blood specimens were collected for measurement of fibrinogen and total WBC. The adhesions were blindly assessed 3 weeks later by using a computerized tensiometer. The fibrinogen and total WBC values of two groups showed no statistical significances. The mean tensile strength (gram force, gf) of formed adhesions day 21 after surgery was $88.1\;{\pm}\;55.70gf$ in the 0.1 % HA group and $24.8\;{\pm}\;22.69gf$ in the HA-CMC group. The tensile strength values of adhesion separation HA-CMC membrane group was significantly lower than the 0.1HA group (p<0.05). Therefore, we suggest that HACMC membrane reduce peritoneal adhesions may be applicable to preventing post-operative intraperitoneal adhesions in dogs.

Minilaparotomy 불임술(不妊術)과 복강경불임술(腹腔鏡不妊術)에 관(關)한 비교연구(比較硏究) (A Comparison of Minilaparotomy and Laparoscopic Sterilization)

  • 배병주
    • Clinical and Experimental Reproductive Medicine
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    • 제4권1호
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    • pp.17-25
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    • 1977
  • Anderson(1937), Power and Barnes(1941) reported a study concerning a method of tubal sterilization in association with peritoneoscopy or laparoscopy in which they cauterized the tubes. There appears to have been a hiatus of interest in sterilization (cold or hot) associated with laparoscopy until reintroduction by Palmer(1963), Frangenheim(1964) and Steptoe(1967). On the other hand, for interval female sterilization, however, minilaparotomy is relatively new. By Saunder and Munsick(1972), John Lyle(1974), Frank Stubb(1974), Vitoon(1973) and B.C. Bai(1975), their own technique for interval female sterilization requires 2.0 to 2.5cm, incision at the margin of the mons pubis. In Korea, female sterilization by means of minilaparotomy firstly reported by B.C. Bai using Bai's uterine elevator, of his own device, early in 1975. Recently inteval female sterilization by laparoscopy and minilaparotomy are widely accepted throughout the world especially in Asian countries. Minilaparotomy is carried out from 1974, laparoscopic sterilization from 1976, and in this study each of 250 cases of those were analysed and discussed for the comparison at Seoul Red Cross Hospital. (1) In the age distribution, numerous clients were in their age of $31{\sim}35$ in laparoscopy as well as minilaparotomy. Average 33.7 years in L and 33.2 years in M. (M=minilaparotomy, L=laparoscopic sterilization) (2) As regarding living children, women having 3 children represented the greatest number, 113 cases out of 250 in M group and 102 cases out of 250 in L group. Average No. of child are 2.9 in Land 3.1 in M. (3) Concidering the operation day in the menstrml cycle, the greatest number of cases, those who underwent tubal sterilization during the days of $26{\sim}$, next during the $6{\sim}10$ days of the cycle in both group. (4) Concidering the operation time, 188 cases by laparoscopy were performed in $6{\sim}10$ minutes, 33 cases within 5 minutes and 24 cases in $11{\sim}15$ minutes. Maximum 50 minutes, minimum 4 minutes and average 8.3 minutes. The majority of cases (154 cases) by minilaparotomy required $6{\sim}10$ minutes and 67 cases $11{\sim}15$ minutes, 6 cases within 5 minutes. Maximum 30 minutes, minimum 4 minutes and average 10.4, minutes. In both groups, most of the reasons for the extra length were surgical difficulties such as thick abdominal wall, pelvic adhesion, less cooperation of patients in early period of this study. (5) Hospital stay after operation in L group required $3{\sim}4$ hours in 125 cases, $2{\sim}3$ hours in 41 cases, $4{\sim}5$ hours in 32 cases out of 250. Maximum 8 hours, minimum 1 hour and average 3.8 hours. In M group hospital stay required $6{\sim}7$ hours in 100 cases, over 7 hours in 85 cases, $5{\sim}6$ hours in 46 cases and so on. Maximum 14 hours, minimum 2 hours and average 6.5 hours. (6) The time between operation and gas passing in the majority cases of both groups, were $12{\sim}36$ hours. A veragetime 20.3 hours in L and 27.2 in M. (7) Laparoscopic sterilization coincident with induced abortion were carried out in 27 cases, laparoscopy with minilaparotomy to control for mesosalpingeal hemorrhage in 1 case. Minilaparotomy coincident with induced abortion were performed in 65 cases, D and C whit polypectomy, menstrual regulatian, and remaval of IUD in 1 case respectively. (8) In L group, 1 case of mesosalpingeal hemorrhage, 1 case of abdominal wall infection were complicated during operation. In M group, 1 case of uterine perfaration, 1 case of abdominal wall infection, 1 case of hemorrhage from omentum and 1 case of bloody vaginal discharge were complicated. No intensive medical treatment was required for those minor complications in both groups. (9) No failure has been recognized and these two sterilization techniques might be the simple, safe and the most effective method for permanent contraception at present time. There is no significant clinical defference between L and M group in this study.

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개에서 내시경을 이용한 경위장관 담낭절제술 1예 : 자연개구부 내시경수술 (Transgastric Endoscopic Cholecystectomy in a Dog : Natural Orifice Transluminal Endoscopic Surgery)

  • 정성목;김영일;이재연;지현철;박지영;박종헌;김지연;이상일;김명철;신상태;이영원
    • 한국임상수의학회지
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    • 제24권3호
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    • pp.315-319
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    • 2007
  • 1년령, 암컷, 15 kg의 잡종견에서 위내시경을 이용한 경위장관 담낭절제술을 최소한의 복강경 도움아래에서 성공적으로 수행하였다. 내시경용 바늘 절개도를 이용하여 배쪽 유문부에서 위절개를 실시하였다. 위절개부를 통하여 내시경을 복강내로 진입한 다음 뒤쪽으로 돌려서 담낭쪽 시야를 확보하였다. 술야의 확보를 위해 복강경용 겸자를 이용하여 담낭의 바닥부위를 부드럽게 들어올렸다. 담낭관과 동맥을 내시경용 endoclip을 이용하여 3중 결찰하였다. 담낭관과 동맥을 절단한 후 내시경용 소작겸자와 바늘 절개도를 이용하여 담낭을 간으로부터 분리하였다. 분리된 담낭은 내시경을 이용해 입을 통하여 제거하고, 위절개부위는 내시경용 endoclip을 이용하여 봉합하였다. 술후 3일째 방사선검사 및 혈청화학검사를 통해 위봉합부위의 천공이 없음과 담즙의 누출이 없음을 확인하였다. 술후 16일째 위내시경과 복강경 검사를 실시하였다. 위내시경검사 결과 봉합부위가 완전히 유합 되었음을 확인하였고 복강경 검사를 통해 담낭절제부위와 위절개부의 장막에 대망막이 유착되어있음을 확인하였다. 본 연구는 개에서 자연개구부 내시경수술(NOTES)을 이용한 담낭절제술의 최초 보고로써 새로운 방법에 의한 담낭절제술에 대한 가능성을 제시한다.