• Title/Summary/Keyword: abdominal wall

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Management of Empyema Caused by a Gastropleural Fistula - A case report - (위늑막루에 의한 농흉의 치험 - 1예 보고 -)

  • Lee, Seong-Kwang;Lee, Yang-Haeng;Jeon, Hee-Jae;Yoon, Young-Chul;Hwang, Youn-Ho;Park, Kyung-Taek;Choi, Chang-Soo
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.340-343
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    • 2010
  • Gastropleural fistula is a rare complication of prior lung surgery, gastric ulcer, trauma and malignancy. A 62 year old female patient who had received surgical repair of a perforated gastric wall 10 years prior, underwent open pleural decortication. At 4 days after surgery, food residuums were noticed at the chest bottles. Hence, an emergency esophagogram was done. The esophagogram revealed a gastropleural fistula. The patient received a total gastrectomy, intra-abdominal diaphragmatic repair and massive thoracic saline irrigation through a previous thoracic wound. The patient was discharged 11 days after surgery without other morbidity.

Infection Route of Scuticociliates in the Juvenile of the Cultured Flounder, Paralichthys olivaceus (양식넙치, Paralichthys olivaceus 치어의 스쿠티카충 감염경로)

  • Jin, Chang-Nam;Lee, Chang-Hun;O, Sang-Pil;Na, O-Su;Heo, Mun-Su
    • Journal of fish pathology
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    • v.16 no.1
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    • pp.13-21
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    • 2003
  • The infection characteristics with scuticociliates at on-land rearing farms and hatcheries of flounder, Paralithys olivaceus was investigated during the year of 2001 by juvenile infection routes. When culture tanks for living food organisms such as chlorella, rotifer, and Artemia were searched, scuticocilates were detected both in live and dead rotifer, and at the dregs of culture tank bottoms at almost hatcheries. When rotifer infected with scuticocilates fed on fish larvae, lots of scuticocilate were inhabited at the bottom of fry rearing tanks. After feeding on scuticocilates-infected rotifer on fish larvae, first infection was detected at 10 days after bottom dwelling or 40 days old after hatching. By histopathological examination we confirmed the infection route of eyeball or brain contamination was that the ciliate worms digged through mouth and front part of the dosal fin cuticle, transferred into eyeball along the epithelium and muscle tissue, and reached finally into brain by the muscle and nerve tissue. The infection of internal organs was clarified into two routes. The first route was started from the infection at ventral and anal fin rays by the worms, and reached at the anus and rectum through the epithelium and muscle tissue. The second route was initiated from the infection at urinary organ and reached into the rectum epithelium cells, inner wall of intestine, abdominal cavity, pancreas, kidney, and pancreas. At seed production farms where fish larvae fed on scuticocilate-free rotifer, the worms were not detected not only at the food organisms culture tanks and juvenile rearing tanks but also larval flounder less than 7cm in total length.

Mesenchymal Chondrosarcoma - 3 Cases Report - (간엽성 연골육종 - 3례 보고 -)

  • Gu, Mi-Jin;Bae, Young-Kyong;Choi, Joon-Hyuk;Kim, Mi-Jin;Choi, Won-Hee;Shin, Duk-Seop;Suh, Jang-Soo
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.87-92
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    • 2000
  • Mesenchymal chondrosarcoma is a rare malignant tumor of skeletal and extraskeletal origin, and which shows aggressive local behavior as well as a high metastatic potential. We report 3 cases of mesenchymal chondrosarcoma. Two cases were male and one was female. Their ages ranged from 25 to 32 years(mean: 28 years). Tissue was obtained by wide excision in two patients. and by incisional biopsy in one. The mass was located in the rib(case 1), orbital floor(case 2), and abdominal wall(case 3). Roentgenographically, the tumor resembles ordinary chondrosarcoma, showing osteolytic and obstructive appearance with stippled calcification. Grossly, the tumor was lobulating, solid fish-fleshy like mass with calcification and ossification. Histologically, the tumor shows characteristic bimorphic pattern composed of islands of well differentiated hyaline cartilage admixed with a cellular area of undifferentiated small cells. The small cells usually displayed a hemangiopericytoid or an alveolar pattern.

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Exogenous Estrogen Toxicity in a Dog (개의 외인성 에스트로겐 중독 증례)

  • Han Jae-Ik;Kim Tae-Hun;Lee Sook-Jin;Kang Ji-Hoon;Cho Sang-Hee;Chang Dong-Woo;Yang Mhan-Pyo;Na Ki-Jeong
    • Journal of Veterinary Clinics
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    • v.23 no.2
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    • pp.197-201
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    • 2006
  • A 2-year-old female mongrel dog was referred to the Veterinary Medical Center of Chungbuk National University due to anorexia, depression and weight loss after the administration of exogenous estrogen for contraception in the local hospital. Although the dog was medicated with antibiotics and fluid for two weeks in the local hospital, there was a deterioration in the patient's general condition. Therefore the dog was referred to our Veterinary Medical Center. Hematological and biochemical analysis showed non-regenerative anemia, thrombocytopenia, severely immature leukocytosis, hyperbilirubinemia, hyperglycemia and elevated serum alkaline phosphatase, gamma-glutamyltransferase, and lactate dehydrogenase. Abdominal ultrasonography showed double line of gallbladder and irregular hypertrophic wall of uterus. On the basis of these examination's results and history taking, final diagnosis was exogenous estrogen-induced myelotoxicosis with cholecystitis and endometritis. The symptomatic therapy for estrogen toxicosis was performed for 26 days after the final diagnosis. However, the symptom had no response to therapy except endometritis and anemia. On day 135 after administration of estrogen, platelet and neutrophil count were normalized, but monocytic leukocytosis was occurred.

Topography of Deep Inferior Epigastric Perforator Flap (심부하복벽천공지의 국소해부학적 고찰)

  • Kim, Chang-Yeon;Oh, Jung-Keun;Hwang, Weon-Jung;Kim, Jeong-Tae;Ahn, Hee-Chang
    • Archives of Reconstructive Microsurgery
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    • v.11 no.2
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    • pp.141-145
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    • 2002
  • Rectus abdominis muscle free flap is widely used for breast reconstruction and soft tissue defect in lower leg but donor-site morbidities such as abdominal wall weakness, hernia, bulging are troublesome. Recently, to minimize donor-site morbidity, there has been a surge in interest in deep inferior epigastric perforator(DIEP) free flap preserving the anatomy of rectus abdominis muscle, fascia, and motor nerve. Between August of 1995 and September of 2002, topographic investigation of DIEP was performed during the elevation of 97 cases of TRAM free flap and 5 cases of DIEP free flap. There were 84 cases of breast reconstructions, 12 cases of lower leg reconstructions, and 6 cases of head and neck reconstruction. We could observe total 10 to 12 perforators on each rectus abdominis muscle below umbilicus. Among these, the numbers of large perforators(>1.5mm of diameter) were mean 2.1 in lateral half of rectus abdominis muscle, mean 1.2 in medial half, and mean 0.5 in linea alba and paramedian. DIEP free flap provides ample amount of well vascularized soft tissue without inclusion of any rectus abdominis muscle and fascia and minimizes donor-site morbidity. One perforator with significant flow can perfuse the whole flap. For large flap, a perforator of the medial row provides better perfusion to zone-4 than one of lateral row and, if diameter of perforator is small, $2{\sim}3$ perforators can be used. According to the condition of recipient-site, thin flap can be harvested. As DIEP free flap has many advantage, perforator topography will be useful in increasing clinical usage of DIEP free flap.

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Cognitive Investigation Study of Patients Admitted for Cosmetic Surgery: Information, Expectations, and Consent for Treatment

  • Barone, Mauro;Cogliandro, Annalisa;La Monaca, Giuseppe;Tambone, Vittoradolfo;Persichetti, Paolo
    • Archives of Plastic Surgery
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    • v.42 no.1
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    • pp.46-51
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    • 2015
  • Background In all branches of medicine, it is the surgeon's responsibility to provide the patient with accurate information before surgery. This is especially important in cosmetic surgery because the surgeon must focus on the aesthetic results desired by the patient. Methods An experimental protocol was developed based on an original questionnaire given to 72 patients. The nature of the responses, the patients' motivation and expectations, the degree of patient awareness regarding the planned operation, and the patients' perceptions of the purpose of the required consent for cosmetic surgery were all analyzed using Fisher's exact test. Results Candidates for abdominal wall surgery had significantly more preoperative psychological problems than their counterparts did (P=0.035). A significantly different percentage of patients under 40 years of age compared to those over 40 years of age searched for additional sources of information prior to the operation (P=0.046). Only 30% of patients with a lower educational background stated that the preoperative information had been adequate, whereas 92% of subjects with secondary schooling or a postsecondary degree felt that the information was sufficient (P=0.001). A statistically significant difference was also present between patients according to their educational background regarding expected improvements in their quality of life postoperatively (P=0.008). Conclusions This study suggests that patients require more attention in presurgical consultations and that clear communication should be prioritized to ensure that the surgeon understands the patient's expectations.

Various Applications of Deep Inferior Epigastric Artery Perforator Free Flap (심부하복벽천공지 유리피판의 다양한 임상적 적용)

  • Ahn, Hee Chang;Yang, Eun Zin;Kim, Chang Yeon;Lee, Jang Hyun
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.707-713
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    • 2009
  • Purpose: The deep inferior epigastric perforator(DIEP) free flap is well known as an ideal donor site for the breast reconstruction. The flap can provide huge amount of fat tissue for breast and buttock contour, while it is also very useful as a thin skin flap to reconstruct the upper and lower extremities. We used a DIEP free flap in various site reconstructions besides the breast and would like to reinsure the usefulness of this flap. Methods: Twenty nine consecutive patients who underwent DIEP free flap surgery from 2001 January to 2007 December were reviewed. The case constituted seven male patients and twenty two female patients. There were sixteen breast reconstructions, five face reconstructions, five lower extremity reconstructions, two upper extremity reconstructions, and one buttock contour reconstruction. All clinical data were based on the patient's medical records. Results: All DIEP free flaps survived without major complications. There was no hematoma, seroma, or partial necrosis. The donor sites were closed primarily with linear scar on lower abdomen. The thinnest part of flap was 0.7 cm in thickness. The size of the largest flap was $38{\times}13cm$. The flaps were used in various types of skin and adipose tissue, adipose tissue only, and skin only according to the requirement of recipient site. Conclusion: The DIEP free flap was enough to provide a thin and huge flap for both breast and extremity reconstructions. It was able to provide versatile designs with sufficient adipose tissue. So we use it for 3 - dimentional face and buttock contour reconstructions. The DIEP free flap is a valuable reconstructive donor for face, upper and lower extremity in addition to breast without compromising the integrity of abdominal wall.

SOFT TISSUE RESPONSE TO THE PULSED Nd : YAG LASED DENTAL IMPLANTS IN THE RABBIT ABDOMINAL WALL (Pulsed Nd : YAG 레이저를 조사한 임플란트를 가토복강내에 이식시 주위조직에 미치는 영향)

  • Jun, Joong-Hyun;Lee, Ho-Yong
    • The Journal of Korean Academy of Prosthodontics
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    • v.34 no.4
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    • pp.800-815
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    • 1996
  • Pulsed Nd : YAG laser has been used to treat various soft tissue lesions. However, there have been warnings of using laser to treat peri-implantitis because the laser can alter the surface of implant and can rise its temperature so that it might be harmful to implant itself and its surrounding tissue. However, the study in vivo has not been done yet. The purpose of this study was to evaluate the biocompatibility to the pulsed Nd:YAG lased dental implant. 16 HA coated implants and 16 titanium plasma sprayed implants were used. They were divided 4 groups as unlased control, 0.3 watt, 1.0 watt and 2.0 watt lased groups after lasing. And they were implanted in the peritonial walls of 12 rabbits. The rabbits were sacrificed 6 weeks after implantation and the LM and EM specimems were made. 1. In the unlased implant group, both HA coated and titanium plasma sprayed implants were surrounded by fibroblasts and collagen fibers. No macrophages and inflammatory cells were seen. 2. In HA coated implants 0.3 watt, 1.0 watt lased group had a little inflammation, but in 2.0 watt lased group had scattered macrophages, a significantly larger number of chronic imflammatory cells were seen. 3. In titanium plasma sprayed implant 0.3 watt, 1.0 watt lased group had a little inflammation, but in 2.0 watt group had severe inflammation as in the conditions of HA coated group. 4. The inflammatory reaction of both lased HA coated and titanium plasma sprayed implant groups increased as the increase of the power of the laser.

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Imaging Diagnosis: Heartbase Tumor in a Dog (개의 심기저부 종양의 영상진단학적 특징)

  • Chang, Jin-Hwa;Jung, Joo-Hyun;Yoon, Jung-Hee;Choi, Min-Cheol
    • Journal of Veterinary Clinics
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    • v.25 no.1
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    • pp.48-51
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    • 2008
  • A ten-year-old Yorkshire Terrier developed serious abdominal distension and respiratory distress. Radiography and ultrasonography revealed a hyperechoic mass around the aorta that was contiguous with the right atrium and main pulmonary artery. It was resulted in failure of the right side of the heart including tricuspid regurgitation, hepatomegaly with dilation of the hepatic vein and severe ascites due to a large, expansile mass. Computed tomography(CT) identified a large mass originating at the cardiac hilar region and spanning from the cranial vena cava to the caudal vena cava. The tumor had invaded the cranial vena cava, caudal vena cava, heart and pleural wall. A tentative diagnosis of chemodectoma was assigned to the tumor through a fine needle aspiration. This report focuses on the typical features of imaging diagnosis of heartbase tumors by radiography, ultrasonography and CT.

Characteristics of Multiple Organ Failure in Baby Rats (어린 백서에서 패혈증으로 유발된 다발성 장기 부전증의 특성)

  • Yoo, Soo-Young;Roh, Kwang-Soo;Jung, Jin-Hyung;Kim, Il-Ho;Ko, Yong-Taek
    • Advances in pediatric surgery
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    • v.6 no.1
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    • pp.10-18
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    • 2000
  • Multisystem organ failure resulting from gram negative bacterial sepsis is associated with high morbidity and mortality in surgical neonates. There are differences in the clinical characteristics of organ failure in neonates and adults. The purpose of this study is to identify the differences and determine the order of organ failure between baby rats and adult rats after induction of gram negative sepsis. Fifty baby rats less than 30-day-old and another 50 adult rats more than 2-month-old were divided into control group (G1) and experimental group (G2). The G1 consisted of 10 baby- and 10 adult-rats, and the G2 consisted of 40 babies and 40 adults. E. coli ($10^8/mL$ per 100g of body weight) were injected into the peritoneal cavity in G2 and same amount of saline was injected in G 1. Blood samples were obtained before injection, 24 hour, 48 hour, 72 hour and after death. WEC, platelet, $PaO_2$, $PaCO_2$, total bilirubin, BUN, creatinine, albumin and abdominal wall thickness were measured to evaluate the sequence of organ failure. The mortality was 55.0 % in G2-babies and 32.5 % in G2-adults. In baby rats, microvascular, hematologic and renal failure appeared within 24 hours after injection and pulmonary failure followed. Pulmonary, renal and liver failure developed within 24-48 hours in adult rats; however, microvascular failure did not appear until they were moribund. Thrombocytopenia, hypoalbuminemia, increased BUN and generalized edema was the earlist sign of sepsis in baby rats.

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