• 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.

• Clinical and Experimental Pediatrics
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• 제51권7호
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• pp.760-765
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• 2008

폐흡충증은 갑각류나 생가재 내의 Paragonimus의 유충의 섭취로 발생하는 기생충 감염이다. 폐 폐흡충증이 가장 흔한 임상 양상이지만 몇몇 이소 폐흡충증이 보고되고 있다. 그 가운데 피하조직의 폐흡충증은 매우 드물다. 6개월 전 게장을 먹은 과거력이 있는 2세 5개월 남아가 우측 복벽의 종류를 주소로 내원하였다. 흉부 X선과 CT 상 폐실질에 이상 없이 우측 흉수만 발견되었고 간비대를 보이고 있었다. 말초혈액 검사상 호산구 증다증을 동반한 백혈구 증가증 및 혈청 면역글로불린 E의 상승을 보였다. 이후 ELISA 상 폐흡충 항체에 양성반응을 보여 P. westermani에 의한 흉수를 동반한 피하조직의 폐흡충증으로 진단할 수 있었다. 환아는 praziquantel 복용으로 치료를 하였으나 피하조직의 폐흡충증 종류가 더 악화되어 이를 수술적으로 제거하였고 조직검사상 기생충의 감염으로 의심되는 염증반응을 관찰할 수 있었다. 이에 본 저자들은 소아에서 감염된 피하조직의 폐흡충증의 드문 증례를 보고하는 바이다.

• 한국임상수의학회지
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• 제31권6호
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• pp.515-518
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• 2014

배뇨실금, 변비를 보이는 중성화된 수컷 요크셔테리어가 내원하였다. 신체검사에서 배뇨곤란 증상이 확인되었고 신경학적 이상은 발견되지 않았다. 또한 요검사에서 세균이 확인 되지 않았으며 직장 검사에서 정상 크기의 전립선을 확인 할 수 있었다. 요도 카테터는 저항감 없이 삽입 되었으며 비뇨기계 조영 촬영에서 골반강 내에 위치한 방광이 확인 되었다. 이소성 요관과 같은 선천적 이상은 확인 되지 않았으며 골반강 내 방광을 동반한 요도 조임근 기능 부전증이 진단 되었다. 방광을 복강내 정상 위치로 환납하기 위한 방광 고정술이 결정 되었다. 와욕 봉합을 이용 방광목 부분을 복벽 및 치골 앞 인대에 고정하였으며 추가적으로 방광 외측 부분을 복벽에 고정하였다. 방광 상단 부위는 복벽 절개창 부위에 고정 하였다. 수술 후 배뇨를 돕기 위해 방광내 카테터를 장착하였으며 수술 후 3일 째 제거하였다. 카테터 제거 후 3 일째 정상 배뇨가 확인되었으며 수술 후 2 달째 방광 조영 촬영을 통해 방광이 복강 내에 정상적으로 위치한 것을 확인하였다. 보호자와의 지속적인 전화 통화를 통해 수술 후 3년 11개월까지 정상 배뇨를 확인하였다.

• 한국식품과학회지
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• 제35권3호
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• pp.488-492
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• 2003

S. cereviaiae KCTC 7911에 돌연변이를 유도하고 selective pressure로서 세포벽 분해효소인 zymolsae와 mechanical stress인 glass bead를 차례로 처리하여 효모변이주를 S. cerevisiae IS2를 선발하였다. S. cerevisiae IS2는 세포벽 분해효소인 zymolase의 농도별 내성실험 결과 wild-type에 비해 훨씬 강한 내성을 보여 세포벽에 변화가 일어난 균주로 예상된다. 효모변이주와 wild-type으로부터 베타글루칸을 추출하여 면역활성에 미치는 영향을 조사하기 위해 생쥐의 복강에 주사하고 생성되는 면역세포의 수, NO 생성능, 및 면역세포의 대다수를 차지하는 대식세포의 탐식능을 측정하였다. 베타글루칸을 쥐의 복강에 주사하였을 때 베타글루칸의 종류에 상관없이 면역세포의 수, NO 생성능 및 대식세포의 활성도가 증가하는 결과를 얻을 수 있었다. 특히 변이주 베타글루칸을 주사하였을 경우 wild-type 베타글루칸에 비해 면역세포의 수는 1.40배, NO 생성능은 1.12배, 대식세포의 활성도와 탐식능은 각각 1.18배와 1.43배 높은 수치를 얻을 수 있었다. 이러한 결과들로 미루어 변이주 베타글루칸이 wild-type 베타글루칸보다 우수한 면역활성 촉진능력을 가지고 있음을 증명할 수 있었으며, 고부가가치 기능성 면역물질로서의 응용 가능성을 확인할 수 있었다.

• Investigative Magnetic Resonance Imaging
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• 제21권3호
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• pp.162-170
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• 2017

Purpose: To evaluate the imaging findings of desmoid tumors using various imaging modalities and to evaluate whether diffusion-weighted imaging (DWI) can help differentiate between desmoid and malignant tumors. Materials and Methods: The study included 27 patients with pathologically confirmed desmoid tumors. Two radiologists reviewed 23 computed tomography (CT), 12 magnetic resonance imaging (MRI) and 8 positron emission tomography-computed tomography (PET-CT) scans of desmoid tumors and recorded data regarding the shape, multiplicity, size, location, degree of enhancement, and presence or absence of calcification or hemorrhage. The signal intensity of masses on T1- and T2-weighted imaging and the presence or absence of whirling or band-like low signal intensity on T2-weighted imaging were recorded. The apparent diffusion coefficient (ADC) values of the desmoid tumors in nine patients with DWIs were compared with the ADC values of 32 malignant tumors. The maximum standardized uptake value ($SUV_{max}$) on PET-CT images was measured in 8 patients who underwent a PET-CT. Results: The mean size of the 27 tumors was 6.77 cm (range, 2.5-26 cm) and four tumors exhibited multiplicity. The desmoid tumors were classified by shape as either mass forming (n = 18), infiltrative (n = 4), or combined (n = 5). The location of the tumors was either intra-abdominal (n = 15), within the abdominal wall (n = 8) or extra-abdominal (n = 4). Among the 27 tumors, 21 showed moderate to marked enhancement and 22 showed homogeneous enhancement. Two tumors showed calcifications and one displayed hemorrhage. Eleven of the 12 MR T2-weighted images showed whirling or band-like low signal intensity areas in the mass. The mean ADC value of the desmoid tumors ($1493{\times}10^{-6}mm^2/s$) was significantly higher than the mean of the malignant soft tissue tumors ($873{\times}10^{-6}mm^2/s$, P < 0.001). On the PET-CT images, all tumors exhibited an intermediate $SUV_{max}$ (mean, 3.7; range, 2.3-4.5). Conclusion: Desmoids tumors showed homogenous, moderate to marked enhancement on CT and MRI scans and a characteristic whirling or band-like pattern on T2-weighted images. DWI can be useful for the differentiation of desmoid tumors from malignant soft tissue tumors.

• Clinical and Experimental Pediatrics
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• 제51권6호
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• pp.655-659
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• 2008

전신 홍반 루푸스는 다양한 증상으로 발현되는 자가면역질환이다. 위장관 증상도 질환의 경과 중에 나타날 수 있으나, 장 가성 폐쇄로 처음 진단되는 경우는 소아에서 매우 드물다. 장 가성 폐쇄는 원발성 또는 속발성으로 장의 평활근이나 신경계에 이상이 있어 해부학적 원인 없이 장폐쇄의 증상과 징후가 나타나는 것이며, 장폐쇄로 인하여 수술을 하였다는 보고도 있다. 그러나 장 가성 폐쇄가 전신 홍반 루푸스에 속발한 경우 장간막 혈관의 폐쇄와 장괴사로 진행하기 전에 조기에 진단하고 치료하면 합병증을 예방하고 수술을 피할 수 있다. 저자들은 장 가성 폐쇄의 증상으로 내원한 13세 여아에서 전신 홍반 루푸스를 진단하여, 불필요한 수술을 피하고 조기에 치료한 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Advances in pediatric surgery
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• 제20권2호
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• pp.38-42
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• 2014

Purpose: Gastroschisis and omphalocele are major anterior abdominal wall defects. The purpose of this study was to analyze the clinical differences and mortalities of gastroschisis and omphalocele in Asan Medical Center. Methods: A retrospective review of the medical records was conducted of 103 cases of gastroschisis and omphalocele from September 1989 to February 2013 in Asan Medical Center in Korea. Results: There were 43 cases (41.7%) of gastroschisis and 60 cases (58.3%) of omphalocele. There was a female predominance in both gastroschisis (60.5%) and omphalocele (58.3%). The average gestational age at delivery was $36.7{\pm}0.4$ weeks for both groups. The mean birth weights were $2,381.9{\pm}80.6g$ for gastroschisis and $2,779.4{\pm}82.8g$ for omphalocele (p=0.001). Mean maternal ages in the gastroschisis and omphalocele groups were $27.5{\pm}0.7$ years and $30.5{\pm}0.7$ years, respectively (p=0.002). Associated malformations were documented in 13 infants (30.2%) with gastroschisis and 46 infants (76.7%) with omphalocele (p<0.001). All of gastroschisis patients except one underwent surgery including 31 primary repairs and 11 staged repairs. Fifty-two infants with omphalocele underwent surgery-primary repair in 41 infants and staged repair in 11 infants. Among 103 cases, 19 cases (18.4%) expired. Mortality rates of gastroschisis and omphalocele were 23.3% (10/43 cases) and 15.0% (9/60 cases), respectively (p=0.287). The main causes of death were abdominal compartment syndrome (6/10 cases) in gastroschisis, respiratory failure (4/9 cases) and discharge against medical advice (4/9 cases) in omphalocele. Conclusion: Gastroschisisis was associated with younger maternal age and lower birth weight than omphalocele. Associated malformations were more common in omphalocele. The mortality rates did not make a statistical significance. This might be the improvement of treatment of cardiac anomalies, because no patient died from cardiac dysfunction in our study. Furthermore, abdominal compartment syndrome might be the main cause of death in gastroschisis.

• The Korean Journal of Physiology
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• 제1권2호
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• pp.157-168
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• 1967

The entry of antipyrine and urea from the peritoneal cavity of rabbit into organ tissue and blood plasma was studied. Two hundred mg of antipyrine plus 300 mg of urea in 10 ml Ringer's solution was injected into the peritoneal cavity of anesthetized rabbit. The injection was made from above of a rabbit kept tying right side down and it enabled part of the abdominal organs (liver, intestine, kidney) was immersed in the injected solution and kept high concentration gradient throughout the experimental period. The remaining part of the organs was revered only by a thin film of the test solution. Subsequently, in this part of the organs the concentration gradient of the diffusible substances during entry was presumed to decrease as time elapsed. Four pieces of the liver tissue were taken namely, the right superficial, right deep, left superficial and left deep portions. Two were taken from the small intestine, one from the portion which was immersed in. the fluid and the other from that above the fluid mass. Both kidneys were separately analyzed. As a remote organ the gastrocnemius muscle was taken from the right leg of the animal. The intervals which were the time periods elapsed after injections were 5,7,10,15 or 30 minutes. At each point 5 animals were sacrificed and the concentrations of the test substances in the tissue water were measured. The results obtained were as follows. 1. In the liver the right portion which was immersed in the fluid showed higher concentration if the test substances than the left portion and the superficial region exceeded the deep region. The concentrations diminished as the time elapsed after infusion, particulary in the case of antipyrine, suggesting circulatory removal of the substances. In urea such decreasing tendency of the concentration was not obvious, and suggested slower removal rate of it as compared with that of antipyrine. 2. In the small intestine there was no regional difference in the concentration of the test substances. Because of the intestinal motility different portions of the intestine were seemed to have bathed in the fluid of the same concentration. In general the concentrations in the intestinal wall exceeded those of the liver, suggesting a slower removal rate than in the latter. 3. In the kidney the accumulation of the endogenous urea was predominant, and the accumulating mechanism in the renal tissue went on during the period of the experiment. Therefore it revealed increasing tendencies as the time elapsed. The penetration of the test substances in this organ from the peritoneal cavity seemed to be slower than in other abdominal organs, namely liver or small intestine. Part of the test substances in the kidney were obviously brought by the blood stream. 4. Rapid exponential decay of the concentration of antipyrine and of the osmolality of the peritoneal fluid was attributed to the extensive removal through the whole dimension of the peritoneal surface, and the remote organ such as the gastrocnemius muscle attained a fairly close value to that of the abdominal organs in less than 30 minutes. The factors which related to the absorption rate were discussed. They were the concentration gradient, permeability and the regional perfusion rate.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.441-446
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• 2023

Inferior vena cava (IVC) injuries, while accounting for fewer than 0.5% of blunt abdominal trauma cases, are among the most difficult to manage. Despite advancements in prehospital care, transportation, operative techniques, and perioperative management, the mortality rate for IVC injuries has remained at 20% to 66% for several decades. Furthermore, 30% to 50% of patients with IVC injuries succumb during the prehospital phase. A 65-year-old male patient, who had been struck in the back by a 500-kg excavator shovel at a construction site, was transported to a regional trauma center. Injuries to the right side of the infrarenal IVC and the right external iliac vein (EIV) were suspected, along with fractures to the right iliac bone and sacrum. The injury to the right side of the infrarenal IVC wall was repaired, and the right internal iliac artery was ligated. However, persistent bleeding around the right EIV was observed, and we were unable to achieve proximal and distal control of the right EIV. Attempts at prolonged manual compression were unsuccessful. To decrease venous return, we ligated the right superficial femoral vein. This reduced the amount of bleeding, enabling us to secure the surgical field. We ultimately controlled the bleeding, and approximately 5 L of blood products were infused intraoperatively. A second-look operation was performed 2 days later, by which time most of the bleeding sites had ceased. Orthopedic surgeons then took over the operation, performing closed reduction and external fixation. Five days later, the patient underwent definitive fixation and was transferred for rehabilitation on postoperative day 22.

• Journal of Multimedia Information System
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• 제6권4호
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• pp.293-302
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• 2019

In the past, there was a theory that influenza wasn't transmitted directly from birds but was infected to humans via swains. Recently, molecular level research has progressed, and it was confirmed that the avian influenza virus can directly infected to human lung and intestinal epithelial cells. Three pandemicsin the past 100 years were also infected to humans directly from birds. In view of such scientific background, we are developing a method for screening sick birds by monitoring the physiological characteristics of birds in a contactless manner with sensors. Here, the movement of respiratory muscles and abdominal muscles under autonomic innervation was monitored using a magnet and Hall sensor sewn on the thoracic wall, and other multimedia devices. This paper presents and discusses the results of experiments involving continuous periodic noise discovered during flight experiments with a data logger mounted on a Japanese pheasant from 2012 to 2015. A brief summary is given as the below: 1. Magnet and Hall sensor sewn to the left and right chest walls, bipolar electrocardiograms between the thoracic walls, posterior thoracic air sac pressure, angular velocity sensors sewn on the back and hips, and optical reflection of LEDs (blue and green) from the skin of the hips allow observation of periodic vibrations(fasciculations) in the waves. No such analysis has been reported before. 2. These fasciculations are presumed to be derived from muscle to maintain and control air sac pressure. 3. Since each muscle fiber is spatially Gaussian distributed from the sympathetic nerve, the envelope is assumed to plot a Gaussian curve. 4. Since avian trunk muscles contract periodically at all time, we assume that the sympathetic nerve dominates in their control. 5. The technique of sewing a magnet to the thoracic wall and measuring the strength of the magnetic field with a Hall sensor can be applied to screen for early stage of avian influenza, with a sensor attached to the chicken enclosure.