• Advances in pediatric surgery
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• v.7 no.1
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• pp.59-63
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• 2001

The authors, over the last 6 months, have treated 2 patients with perforated typhlitis complicating acute lymphocytic leukemia (ALL) with good outcome. The first patient was a 13-year-old male who developed intermittent high fever, abdominal pain, abdominal distention and diarrhea during the course of maintenance chemotherapy. The peripheral leukocyte ranged from 230-470/$mm^3$. Serial ultra sonograms and CT scans demonstrated irregular thickening of the cecal and ascending colonic walls and subsequent ragged perforation of the posterior wall of the cecum. He survived after treatment by right hemicolectomy and aggressive supportive measures. The patient case was a 3 year-old female who developed intermittent high fever, right lower abdominal pain, a mass, and watery diarrhea during the course of maintenance chemotherapy. Serial ultra sonograms and CT scans demonstrated irregular thickening of the cecal wall (6-15mm in thickness) and subsequent small perforation of the posterior wall of the cecum with thick-walled localized abscess. She has recovered completely after aggressive medical management. We learned two lessons from our experience treating these patients:1) early diagnosis provided by a high index of suspicion and the use of ultra sonogram or CT scan is essential. And 2) although perforation is one of the surgical indications for the treatment of typhlitis, it is possible to manage the perforation nonoperatively in selected cases with localized abscess.

• Archives of Plastic Surgery
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• v.47 no.2
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• pp.146-152
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• 2020

Background Preoperative computed tomography angiography (CTA) of the abdominal wall vessels is used when planning free flap breast reconstruction (FFBR) because it provides a surgical road map which facilitates flap harvest. However, there are few reports on the effect of abnormal findings on the operative plan. Methods We conducted a retrospective study of all FFBRs performed at a tertiary referral center over a 6-year period (November 2011 to June 2017). One consultant radiologist reported on the findings. Details on patient demographics, CTA reports, and intraoperative details were collected. Results Two hundred patients received preoperative CTAs. Fourteen percent of patients (n=28) had abnormal findings. Of these findings, 18% were vascular anomalies; 36% tumorrelated and 46% were "miscellaneous." In four patients, findings subsequently prevented surgery; they comprised a mesenteric artery aneurysm, absent deep inferior epigastric (DIE) vessels, bilateral occluded DIE arteries, and significant bone metastases. Another patient had no suitable vessels for a free flap and the surgical plan converted to a pedicled transverse rectus abdominis musculocutaneous flap. The remaining incidental findings had no impact on the surgical plan or appropriateness of FFBR. More than one in 10 of those with abnormal findings went on to have further imaging before their operation. Conclusions CTA in FFBR can have a wider impact than facilitating surgical planning and reducing operative times. Incidental findings can influence the surgical plan, and in some instances, avoid doomed-to-fail and unsafe surgery. It is therefore important that these scans are reported by an experienced radiologist.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.436-440
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• 2007

Purpose: TRAM flap surgery has settled down as a common method for breast reconstruction after mastectomy. We investigated how TRAM flap surgery influences on the patients' physical movement capability by observing their capability of sit-ups as well as exercises they usually enjoy. Methods: A total of consecutive 375 patients were investigated who had breast reconstruction with unilateral pedicled TRAM flap surgery at Asan Medical Center from July 2001 to August 2005. The patients were asked to sit up right before the surgery and do it again 6 months later and 1 year later. 221 patients were followed up 6 month after the surgery. And 132 patients were followed up 1 year after the surgery. In addition, 155 patients who used to exercise before the surgery were also asked to show us the change in their physical movement capability one year after their surgery. Results: 139 patients showed decrease in the counted number of sit-ups, 48 increase, and 34 showed no change between 6 months in the first group of 221 patients. Among the second group of 132 patients, 64 showed decrease, 39 increase, and 29 no change a year later. There was a statistical significant decrease in the number of sit-ups between pre-operation and six months later and between pre-operation and one year later. According to the research on the exercise that 155 patients participated, 3 of them showed improvement in athletic ability, 7 showed decrease, while the rest, 145 patients, showed no change at all. Conclusion: Considering no difference in usual exercise ability, some patients' increase in the number of sit-ups and the effect of anticancer treatment, we found that the loss of abdominal wall function on this research is not too serious to exclude TRAM flap surgery in the field of breast reconstruction

• Journal of Biomedical Engineering Research
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• v.23 no.3
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• pp.181-187
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• 2002

The objective of the present study was to two-dimensionally investigate the characteristics of flow and wall shear stress under pulsatile flow in the aneurysm which is a local dilatation of the blood vessel for pulsatile flow. The numerical simulation using the commercial software were carried out for the diameter ratios(ratio of maximum diameter of aneurysm to the diameter of blood vessel) ranging from 1.5 to 2.5 and Womersley number, 15.47. It was shown that a recirculating flow at the bulge was developed and disappeared for one Period and the strength of vortex increased with the diameter ratio Especially. at time of 3.19s. the very weak recirculating flow was developed at the left upper sites of the aneurysm. The maximum values of the wall shear stress increased in Proportion to the diameter ratio. However. the Position of a maximum wall shear stress was the distal end of the aneurysm(z = 35mm) regardless of the diameter ratios.

• Journal of Veterinary Clinics
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• v.33 no.1
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• pp.58-61
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• 2016

An 11-year-old, intact male Cocker Spaniel dog was presented with history of abdominal distension, dyspnea for 10 days and lethargy for 1 day. Abdominal radiographs showed decreased serosal detail with abdominal distension. Abdominal ultrasounds revealed gallbladder mucocele with generalized peritonitis showing stellate-like sludge in the gallbladder with echogenic fat degeneration of cranial abdomen and abdominal free fluid containing echogenic materials. Loss of gallbladder wall integrity was shown clearly on computed tomography but ambiguously on ultrasound. Ultrasound-guided abdominocentesis was performed and showed amount of yellowish-bloody peritoneal fluid with vegetable matter and mucoid substance. On peritoneal fluid analysis, bilirubin level was elevated over three times than those of the serum. On exploratory laparotomy, gallbladder rupture and generalized bile peritonitis with intestinal adhesions were confirmed and cholecystectomy with peritoneal lavage was performed. One day after operation, patient died. This report describes delayed clinical symptoms of gallbladder rupture by gallbladder mucocele. In addition, this is the first case report using computed tomography made a diagnosis gallbladder rupture in a dog. Computed tomography might be helpful to diagnose gallbladder rupture.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.6
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• pp.608-612
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• 2019

Gastric volvulus (GV) is an uncommon pathology, with 10-20% of cases occurring in children, typically before one year of age. It often occurs in people with congenital diaphragmatic hernias, intestinal malrotation, eventration of the diaphragm, paraesophageal hernias, wandering spleens, asplenism, or intra-abdominal adhesions. We report a rare case of chronic GV after left hemihepatectomy for hepatoblastoma in a child. The patient was a 9-year-old boy who complained of upper abdominal pain and postprandial upper abdominal distension for one year. At the age of 4 months, he was diagnosed with hepatoblastoma and had undergone left hemihepatectomy. The upper gastrointestinal contrast study revealed chronic organoaxial gastric volvulus. After a surgical procedure involving adhesiolysis and an anterior wall gastropexy, the patient improved and the symptoms resolved. Although GV is a rare disease, it should be suspected in a patient with a previous abdominal surgical history who is complaining of abdominal distension and pain.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1240-1244
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• 1992

Human sparganosis caused by Sparganum mansoni, the larval plerocercoid worm of the genus Spirometra, is not uncommon in Korea and is mostly found in subcutaneous or adipose tissue of the abdominal, thoracic wall and inguinal region, but is rarely found in the orbital cavity, brain and breast. It, at present, is a surgical disease because its diagnosis depends almost on the demonstration of the larva[e] from lesion or finding the worm section in surgical pathology specimens. We experienced a case of human sparganosis from a 48 years old woman who had a history of eating a raw frog. We report the case and review the related literatures.

• Archives of Plastic Surgery
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• v.39 no.5
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• pp.528-533
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• 2012

Background Rectus abdominis muscle and abdominal subcutaneous fat tissue are useful for reconstruction of the chest wall, and abdominal, vaginal, and perianal defects. Thus, preoperative evaluation of rectus abdominis muscle and abdominal subcutaneous fat tissue is important. This is a retrospective study that measured the thickness of rectus abdominis muscle and abdominal subcutaneous fat tissue using computed tomography (CT) and analyzed the correlation with the patients' age, gestational history, history of laparotomy, and body mass index (BMI). Methods A total of 545 adult women were studied. Rectus abdominis muscle and abdominal subcutaneous fat thicknesses were measured with abdominopelvic CT. The results were analyzed to determine if the thickness of the rectus abdominis muscle or subcutaneous fat tissue was significantly correlated with age, number of pregnancies, history of laparotomy, and BMI. Results Rectus abdominis muscle thicknesses were 9.58 mm (right) and 9.73 mm (left) at the xiphoid level and 10.26 mm (right) and 10.26 mm (left) at the umbilicus level. Subcutaneous fat thicknesses were 24.31 mm (right) and 23.39 mm (left). Rectus abdominismuscle thickness decreased with age and pregnancy. History of laparotomy had a significant negative correlation with rectus abdominis muscle thickness at the xiphoid level. Abdominal subcutaneous fat thickness had no correlation with age, number of pregnancies, or history of laparotomy. Conclusions Age, gestational history, and history of laparotomy influenced rectus abdominis muscle thickness but did not influence abdominal subcutaneous fat thickness. These results are clinically valuable for planning a rectus abdominis muscle flap and safe elevation of muscle flap.

• Carbon letters
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• v.7 no.2
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• pp.81-86
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• 2006

During a 3-year period (2001-2004) 18 animals were surgically treated because of abdominal wall defects (hernia). Out of 18 animals 8 were bovines, 5 caprines and 5 canines. In each case the defect was bridged with carbon fibres. Carbon fibres were placed either in simple interrupted pattern or as mattress overlapping pattern. All the cases were successfully treated and no complication was observed up to six months postoperatively.

• Journal of Chest Surgery
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• v.50 no.4
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• pp.291-294
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• 2017

A 74-year-old patient presented with recurrent aneurysms in the infrarenal abdominal aorta and right common iliac artery 6 years after endovascular aortic repair using endografts in the same location. The patient underwent an aorto-bi-iliac replacement with removal of the stent graft. Two holes measuring 2 mm each were found in the removed graft, and they appeared to have been caused by wear from continuous friction between the endograft and the aortic wall.