• Title/Summary/Keyword: cases report

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Portal vein reconstruction in pediatric liver transplantation using end-to-side jump graft: A case report

  • Jaewon Lee;Nam-Joon Yi;Jae-Yoon Kim;Hyun Hwa Choi;Jiyoung Kim;Sola Lee;Su young Hong;Ung Sik Jin;Seong-Mi Yang;Jeong-Moo Lee;Suk Kyun Hong;YoungRok Choi;Kwang-Woong Lee;Kyung-Suk Suh
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.3
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    • pp.313-316
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    • 2023
  • Attenuated portal vein (PV) flow is challenging in pediatric liver transplantation (LT) because it is unsuitable for classic end-to-end jump graft reconstruction from a small superior mesenteric vein (SMV). We thus introduce a novel technique of an end-to-side jump graft from SMV during pediatric LT using an adult partial liver graft. We successfully performed two cases of end-to-side retropancreatic jump graft using an iliac vein graft for PV reconstruction. One patient was a 2-year-old boy with hepatoblastoma and a Yerdel grade 3 PV thrombosis who underwent split LT. Another patient was an 8-month-old girl who had biliary atresia and PV hypoplasia with stenosis on the confluence level of the SMV; she underwent retransplantation because of graft failure related to PV thrombosis. After native PV was resected at the SMV confluence level, an end-to-side reconstruction was done from the proximal SMV to an interposition iliac vein. The interposition vein graft through posterior to the pancreas was obliquely anastomosed to the graft PV. There was no PV related complication during the follow-up period. Using a jump vascular graft in an end-to-side manner to connect the small native SMV and the large graft PV is a feasible treatment option in pediatric recipients with inadequate portal flow due to thrombosis or hypoplasia of the PV.

Transcholecystic Duodenal Drainage as an Alternative Decompression Method for Afferent Loop Syndrome: Two Case Reports (들장관증후군의 대체 감압 치료로서 경담낭 십이지장 배액술: 두 건의 증례 보고)

  • Jihoon Hong;Gab Chul Kim;Jung Guen Cha;Jongmin Park;Byunggeon Park;Seo Young Park;Sang Un Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.661-667
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    • 2024
  • Afferent loop syndrome (ALS) is a rare complication of gastrectomies and gastrointestinal reconstruction. This can predispose patients to fatal conditions, such as cholangitis, pancreatitis, and duodenal perforation with peritonitis. Therefore, emergency decompression is necessary to prevent these complications. Herein, we report two cases in which transcholecystic duodenal drainage, an alternative decompression treatment, was performed in ALS patients without bile duct dilatation. Two patients who underwent distal gastrectomy with Billroth II anastomosis sought consultation in an emergency department for epigastric pain and vomiting. On CT, ALS with acute pancreatitis was diagnosed. However, biliary access could not be achieved because of the absence of bile duct dilatation. To overcome this problem, a duodenal drainage catheter was placed to decompress the afferent loop after traversing the cystic duct via a transcholecystic approach. The patients were discharged without additional surgical treatment 2 weeks and 1 month after drainage.

Papillary Renal Cell Carcinoma in Transplanted Kidney and Xp11.2 Translocation/Transcription Factor E3-Rearranged Renal Cell Carcinoma in the Native Kidney: A Case Report (이식신장에 생긴 유두모양 신세포암종과 고유신장에 생긴 Xp11.2전위/전사인자E3-재배열 신세포암종: 증례 보고)

  • Min Hye Kim;Kyeong Ah Kim;Jeong Woo Kim;Seok Young Lee;Jae Woong Choi
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.437-444
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    • 2024
  • Concomitant renal cell carcinomas (RCC) of both native and allograft kidneys are extremely rare, and only a few cases have been reported in the available English literature. A particularly rare variant within the adult population is the Xp11.2 translocation/transcription factor E3 (TFE3)-rearranged RCC. Although few case reports of TFE3-rearranged RCC have been reported in children who underwent kidney transplantation (KT), no case of adults with TFE3-rearranged RCC following KT has been reported. Herein, we presented the radiological and pathological findings of a rare metachronous papillary RCC in the allograft kidney and TFE3-rearranged RCC in the native kidney. The TFE3-rearranged RCC in the native kidney exhibited slow expansion in size over five years. Radiologically, it appeared as a slightly enhanced, lobulated mass on contrast-enhanced CT. MRI revealed high signal intensity on T1-weighted images and low signal intensity on T2-weighted images.

Gastric Metastasis from Gastric-Type Mucinous Adenocarcinoma of Uterine Cervix: A Case Report (자궁경부 위형 점액샘암종의 위 전이: 증례 보고)

  • Min Hye Kim;Kyeong Ah Kim;Yi Kyeong Chun;Jeong Woo Kim;Jongmee Lee;Chang Hee Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.445-450
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    • 2024
  • Gastric metastasis (GM) from cervical cancer is extremely rare, and only a few cases have been reported in the English literature. Gastric-type mucinous adenocarcinomas (GAS) of the uterine cervix are rare. GAS is an aggressive cancer commonly found in advanced stages; however, GM has not been reported. This study presents a rare case of GM from GAS of the uterine cervix in a 61-year-old female and describes the radiological findings of both the GM and cervical mucinous adenocarcinoma. GM appeared as a poor enhancing submucosal mass. The cervical mucinous adenocarcinoma appeared as an infiltrating mass with poor contrast enhancement. It exhibited mildly high and low signal intensities on the diffusion-weighted image and apparent diffusion coefficient map, respectively. This case is extremely rare and challenging to diagnose; however, if cervical cancer is an human papillomavirus-independent GAS type and a submucosal lesion is found in the stomach, the possibility of metastasis with a pattern similar to our case could be considered.

Implant-assisted removable partial denture restoration in small number of residual teeth in mandible: A case report (하악 소수 잔존치 환자에서 임플란트 보조 국소의치 수복 증례)

  • Jong-Ha Park;Jee-Hwan Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.3
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    • pp.215-223
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    • 2024
  • The patient in this case presented with a desire to have new dentures due to discomfort with existing ones. At the initial visit, all of teeth were missing except for the mandibular left second molar. As the patient was 65 years old, treatment with dentures and implant-supported prostheses was possible under the national health insurance system, and the patient opted for the mandibular denture using implant. Temporary prostheses were initially provided for patient adaptation, and following successful adaptation period, the treatment progressed. A maxillary complete denture and a mandibular implant-supported denture using two implants in the canines were fabricated. The mandibular denture is a Kennedy Class II removable partial denture which consists of a six-unit porcelain fused to metal fixed dental prostheses supported by the implant in the canines on both sides and left second molar serving as the abutments. Despite severe bone resorption and insufficient abutment teeth, the patient expressed satisfaction with the treatment results. In cases with economic and anatomical constraints affecting the feasibility of complete denture, implant-supported overdenture, and implant-supported fixed dental prostheses, an implant-assisted removable partial denture using implant surveyed crowns proves to be a viable and effective alternative treatment option. Nevertheless, the current dearth of scientifically rigorous studies underscores the necessity for meticulous regular check-up and occlusal assessment.

Programmed Follow-up and Quality Control of Treatment Techniques Enhance Chronic Thromboembolic Pulmonary Hypertension Management: Lessons From a Multidisciplinary Team

  • Taek Kyu Park;Sung-A Chang;Jeong Hoon Yang;Woochan Kwon;Min Yeong Kim;Young Seok Cho;Hye Yun Park;Dong Seop Jeong;Hojoong Kim;Duk kyung Kim
    • Korean Circulation Journal
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    • v.54 no.7
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    • pp.409-421
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    • 2024
  • Background and Objectives: The recent developments in chronic thromboembolic pulmonary hypertension (CTEPH) are emphasizing the multidisciplinary team. We report on the changes in clinical practice following the development of a multidisciplinary team, based on our 7 years of experience. Methods: Multidisciplinary team was established in 2015 offering both balloon pulmonary angioplasty (BPA) and pulmonary endarterectomy (PEA) with technical upgrades by internal and external expertise. For operable cases, PEA was recommended as the primary treatment modality, followed by pulmonary angiography and right heart catheterization after 6 months to evaluate treatment effect and identify patients requiring further BPA. For patients with inoperable anatomy or high surgical risk, BPA was recommended as the initial treatment modality. Patient data and clinical outcomes were closely monitored. Results: The number of CTEPH treatments rapidly increased and postoperative survival improved after team development. Before the team, 38 patients were treated by PEA for 18 years; however, 125 patients were treated by PEA or BPA after the team for 7 years. The number of PEA performed was 64 and that of BPA 342 sessions. World Health Organization functional class I or II was achieved in 93% of patients. The patients treated with PEA was younger, male dominant, higher pulmonary artery pressure, and smaller cardiac index, than BPA-only patients. In-hospital death after PEA was only 1 case and none after BPA. Conclusions: The balanced development of BPA and PEA through a multidisciplinary team approach proved synergistic in increasing the number of actively treated CTEPH patients and improving clinical outcomes.

TREATMENT OF MALOCCLUSION, AS RELATED TO FINGER SUCKING : CASE REPORT (손가락 빨기로 인한 부정교합의 치험례)

  • Moon, Sang-Jin;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.1-10
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    • 2004
  • The habit of finger sucking is a reflex occurring in the oral stage, due to nutritive and psychological desire. The habit of finger sucking is considered to be normal till 3 years of age. Dento-skeletal effect on maxillo-mandibular complex including occlusion is naturally correction, when habit stopped before 3 years. If finger sucking continues till $3{\sim}4$ years, Finger sucking leads to severe malocclusion and remarkable discrepancy maxillo-mandibular complex, which is difficult in expectation of natural correction. It is necessary to positive treatment. Treatment of malocclusion, as related to finger sucking is classified two methods. (psychological approach and orthodontic appliance) To stop a habit and to correct severe skeletal discrepancy and malocclusion, $fr\ddot{a}nkel$ appliance is very effective device. This study is to report two cases of treatment of malocclusion, as related to finger sucking. 2 years 10 months old girl with severe overjet, maxillo-mandibular skeletal discrepancy and severe convex facial profile was treated with a FR-II appliance. Finger sucking habit stopped immediately After 16 months, severe overjet, maxillo-mandibular skeletal discrepancy and severe convex facial profile was corrected. 4 years 2 months old girl with midline deviation, mandibular right shift, collateral posterior crossbite and facial asymmetry was treated with a FR-III appliance. Finger sucking habit stopped immediately. After 10 month, Midline deviation, mandibular right shift, collateral posterior crossbite and facial asymmetry were corrected. FR-appliance is a recommendable appliance for a habit breaker and correction of skeletal discrepancy.

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Effect of Interactive Metronome® Training on Timing, Attention and Motor Function of Children With ADHD : Case Report (상호작용식 메트로놈(Interactive Metronome: IM)이 타이밍과 주의력, 운동기능에 미치는 영향: 사례보고)

  • Namgung, Young;Son, Da-In;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.13 no.2
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    • pp.63-73
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    • 2015
  • Objective : To report the effects of a specific intervention, the Interactive Metronome$^{(R)}$ (IM), on timing, attention and motor function of a children with ADHD. Methods : The study is case reports about two boys with ADHD. One boy who is born 2008 is attending general elementary school as a first year student (case 1), and another boy who is born 2001 is attending general elementary school as a second year student (case 2). For each case subject, IM training was provided during 3 weeks, from January 2015 to Febrary 2015. Evaluations were performed pre- and post-intervention in order to exam timing, attention and motor skills. The measurements uses in this study are Long Form Assessment (LFA) for the timing, RehaCom screening module for the attention, and Bruininks-Oseretsky Test of Morot Proficiency, second version (BOT-2) for the motor function. Results : The timing function was improved in both cases since both showed reduced response time for all motor tasks of LFA. In terms of attention, case 1 showed improvement of visual attention division, neglect and response Inhibition, and case 2 showed improvement of sustained attention. Lastly, in the BOT-2, case 1 showed improved the percentile rank of short (from 42%ile to 96%ile), and case 2 also showed similar improvement (from 21%ile to 66%ile). Conclusion : This study provides positive evidence that the Interactive Metronome$^{(R)}$ training has positive power to facilitate several body functions such as timing, attention and motor control of children with ADHD, through two case studies.

Patient's 'Right Not to Know' and Physician's 'Duty to Consideration' (환자의 모를 권리와 의사의 배려의무)

  • Suk, HeeTae
    • The Korean Society of Law and Medicine
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    • v.17 no.2
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    • pp.145-173
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    • 2016
  • A patient's Right to Self-Determination or his/her Right of Autonomy in the Republic of Korea has traditionally been understood as being composed of two elements. The first, is the patient's Right to Know as it pertains to the physician's Duty to Report [the Medical Situation] to the patient; the second, is the patient's Right to Consent and Right of Refusal as it pertains to the physician's Duty to Inform [for Patient's Consent]. The legal and ethical positions pertaining to the patient's autonomous decision, particularly those in the interest of the patient's not wanting to know about his/her own body or medical condition, were therefore acknowledged as passively expressed entities borne from the patient's forfeiture of the Right to Know and Right to Consent, and exempting the physician from the Duty to Inform. The potential risk of adverse effects rising as a result of applying the Informed Consent Dogma to situations described above were only passively recognized, seen merely as a preclusion of the Informed Consent Dogma or a denial of liability on part of the physician. In short, the legal measures that guarantee a patient's 'Wish for Ignorance' are not currently being understood and acknowledged under the active positions of the patient's 'Right Not to Know' and the physician's 'Duty to Consideration' (such as the duty not to inform). Practical and theoretical issues arise absent the recognition of these active positions of the involved parties. The question of normative evaluation of cases where a sizable amount of harm has come up on the patient as a result of the physician explaining to or informing the patient of his/her medical condition despite the patient previously waiving the Right to Consent or exempting the physician from the Duty to Inform, is one that is yet to be addressed; that of ascertaining direct evidence/legal basis that can cement legality to situations where the physician foregoes the informing process under consideration that doing so may cause harm to the patient, is another. Therefore it is the position of this paper that the Right [Not to Know] and the Duty [to Consideration] play critical roles both in meeting the legal normative requirements pertaining to the enrichment of the patient's Right to Self-Determination and the prevention of adverse effects as it pertains to the provision of [unwanted] medical information.

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The Mesh Selectivity of Trawl Cod-end for the Compressed From Fishes (측편형어류에 대한 트롤 끝자루의 망목선택성)

  • Jeong, Sun-Beom;Lee, Ju-Hee;Kim, Sam-Gon
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.29 no.4
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    • pp.247-259
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    • 1993
  • The fishing experiment was carried out by the training ship Saebada in order to analyse the mesh selectivity for trawl cod-end, in the Southern Korea Sea and the East China Sea from June. 1991 through August, 1992. The trawl cod-end used in this experiment has the trouser type of cod-end with cover net. and the mesh selectivity was examined for the five kinds of the opening of mesh in its cod-end part. A total of 163 hauls, of which having mesh size 51.2mm ; A 89, 70.2mm ; B 54, 77.6mm ; C 55, 88.0mm ; D 52 and 111.3mm ; E 20 were used respectively. Selection curves and selection parameters were calculated by using a logistic function, S=1/(1+exp super(-(aL+b)) ). The mesh election master curves were estimated by S=1/(1+exp super(-[a(L/M)+$\beta$]) ). and the optimum mesh size were calculated with (L/M) sub(50) of master curve. In these cases 'a' and '$\alpha$' are slope, 'b' and '$\beta$' are intercept. 'L' is body length of the target species of fishes, 'M' is the mesh size, and 'S' denotes mesh selectivity. In this report, the four species of compressed form fishes were taken analized according to fish shape, and 'S' denotes mesh selectivity. In this report, the four species of compressed form fishes were taken analized according to fish shape, and the results obtained are summarized as follows: 1. Red seabream Pagrus major(Temminct et Schlegel) and yellow porgy Dentex tumifrons(Temminct et Schlegel) ; Selection rate in each mesh size of A, B, C, D and E were 99.7%, 97.5%, 91.4%, 76.7% and 57.8% respectively. Selection parameters 'a' and 'b' of mesh sizes C, D and E were 2.65 and -28.62, 4.40 and -77.73, 2.31 and -46.99, and their selection factors were 1.39, 2.10, 1.83 respectively. Selection parameters of master curve '$\alpha$' and '$\beta$' were 3.05 and -5.65 respectively, and (L/M) sub(50) was 1.85. The optimum mesh size of Red seabream was 141mm. 2. Filefish Thamnaconus modestus (Gunther) ; Selection rate in each mesh size of A, B, C, D and E were 99.6%, 98.3%, 91.2%, 80.0% and 48.6% respectively. Selection parameters 'a' and 'b' of mesh sizes C, D and E were 5.82 and -55.10, 2.92 and -36.90, 3.91 and -63.09, and their selection factors were 1.35, 1.44, 1.45 respectively. Selection parameters of master curve '$\alpha$' and '$\beta$' were 3.02 and -4.32 respectively, and (L/M) sub(50) was 1.43. The optimum mesh size was 129mm. 3. Target dory Zeus faber Valenciennes ; Selection rate in each mesh size of A, B, C, D and E were 99.7%, 100%, 83.2%, 91.6% and 65.0% respectively. Selection parameters 'a' and 'b' of mesh sizes C, D and E were 3.85 and -32.46, 4.19 and -57.38, 2.45 and -40.03, and their selection factors were 1.09, 1.56, 1.47 respectively. Selection parameters of master curve '$\alpha$' and '$\beta$' were 2.64 and -3.53 respectively, and (L/M) sub(50) was 1.34. The optimum mesh size was 127mm. 4. Butterfish Psenopsis anomala (Temminct et Schlegel) ; Selection rate in each mesh size of A, B, C, D and E were 99.2%, 34.1%, 46.5%, 14.3% and 2.4% respectively. Selection parameters 'a' and 'b' of mesh sizes B, C and D were 5.35 and -71.70, 5.07 and -69.25, 3.31 and -62.06 and their selection factors were 1.91, 1.75, 2.13 respectively. Selection parameters of master curve '$\alpha$' and '$\beta$' were 3.16 and -6.24 respectively, and (L/M) sub(50) was 1.98. The optimum mesh size was 71mm.

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