• Title/Summary/Keyword: diaphragmatic defect

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Congenital hernia of the lung through the azygoesophageal recess (Azygoesophageal recess를 통한 선천 폐탈장)

  • Choi, Young Seok;Son, Young Jun;Bae, Si Young;Min, Kyung Sun;Cho, Young Kuk;Choi, Woo Yeon;Choi, Young Youn;Ma, Jae Sook;Hwang, Tai Ju
    • Clinical and Experimental Pediatrics
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    • v.51 no.10
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    • pp.1123-1126
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    • 2008
  • A lung hernia, defined as the protrusion of pulmonary tissue and pleural membranes through a defect in the thoracic wall, is a rare event. It can be congenital or acquired, and cervical, thoracic, or diaphragmatic in location. We report the rare occurrence of a congenital atraumatic lung herniation through the azygoesophageal recess. An 8-month-old male infant, who was born at 35 weeks gestation, had a chronic cough. Chest radiography showed haziness at the right lower lobe of the lung (RLL). Chest computed tomography (CT) revealed herniation of the RLL through the azygoesophageal recess. If persistent unilateral haziness is observed on chest radiography, the possibility of lung herniation should be considered.

A Case of Right Pleural Effusion in Liver Cirrhosis without Ascites (복수가 동반되지 않은 간경변증 환자에서 발생한 우측성 흉막액 저류 1예)

  • Yoon, Jin;Kim, Eung-Jin;Kim, Soon-Hye;Koh, Kwang-Kon;Kim, Moon-Jae;Chung, Won-Jae;Cho, Chul-Ho;Shin, Yong-Woon;Park, Chan-Sup
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.3
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    • pp.261-265
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    • 1992
  • Pleural effusion due to hepatic cirrhosis and ascites is well known. But rarely a pleural effusion may develop in a cirrhotic patient in the absence of detectable ascites. The differential diagnosis of a right-sided transudative pleural effusion in a patient with chronic liver disease with or without ascites includes congestive heart failure and nephrotic syndrome. These diseases are usually ruled out with standard clinical tests. Patients with hepatic hydrothorax should be treated with fluid restriction, diuretics and the correction of hypoalbuminemia. Patients with severe symptoms due to refractory hepatic hydrothorax might benefit from pleural sclerosis and surgical closure of diaphragmatic defect. We experienced a case of right-sided pleural effusion in liver cirrhosis without ascites.

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Radionuclide Peritoneal Scintigraphy in Patients with Ascites and Pleural Effusion (방사성핵종 복막촬영술을 이용한 복수에 동반된 수흉의 감별 진단)

  • Lee, Jae-Tae;Lee, Kyu-Bo;Whang, Kee-Suk;Kim, Gwang-Weon;Chung, Byung-Cheon;Cho, Dong-Kyu;Chung, Joon-Mo
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.2
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    • pp.279-285
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    • 1990
  • Simultaneous presence of ascites and pleural effusion has been documented in patients with cirrhosis of the liver, renal disease, Meigs' syndrome and in patients undergoing peritoneal dialysis. Mechanisms proposed in the formation of pleural effusion in most of the above diseases are lymphatic drainage and diaphragmatic defect. But sometimes, hepatic hydrothoraxes in the absence of clinical ascites and pleural effusion secondary to pulmonary or cardiac disease are noted. It is not always possible to differentiate between pleural effusion caused by transdiaphragmatic migration of ascites and by other causes based soly on biochemical analysis. Authors performed radionuclide scintigraphy after intraperitoneal administration of $^{99m}Tc-labeled$ colloid in 23 patients with both ascites and pleural effusion in order to discriminate causative mechanisms responsible for pleural effusion. Scintigraphy demonstrated the transdiaphragmatic flow of fluid from the peritoneum to pleural cavities in 13 patients correctly. In contrast, in 5 patients with pleural effusion secondary to pulmonary, pleural and cardiac diseases, radiotracers fail to traverse the diaphragm and localize in the pleural space. Ascites draining to mediastinal lymph nodes and blocked passage of lymphatic drainage were also clarified, additionaly. Conclusively, radionuclide peritoneal scintigraphy is an accurate, rapid and easy diagnostic tool in patients with both ascites and pleural effusion. It enables the causes of pleural effusion to be elucidated, as well as providing valuable information required when determining the appropriate therapy.

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Understanding of Fetal Surgery and Application to the Cleft Lip and Palate Patient (태수술에 대한 이해와 구순구개열 환자에서의 적용)

  • Kim, Soung-Min;Park, Jung-Min;Myoung, Hoon;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin
    • Korean Journal of Cleft Lip And Palate
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    • v.11 no.2
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    • pp.49-58
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    • 2008
  • The development of fetal surgery has led to promising options for many congenital malformations, such as congenital diaphragmatic hernia (CDH), obstructive uropathy, twin-to-twin transfusion syndrome (TTTS), and sacrococcygeal teratoma. However, preterm labor (PTL) and premature rupture of membranes continue to be uniquitous risks for both mother and fetus. To reduce maternal morbidity and the risk of prematurity, minimal access techniques were developed and are increasingly employed recently. Lift-threatening diseases as well as severely disabling but not life-threatening conditions are potentially amenable to treatment. Recently, improvement of video-endoscopic technology has boosted the development of operative techniques for feto-endoscopic surgery, which has been demonstrated to be less invasive than the open approach. Fetal surgery for repair of cleft lip and palate, a congenital anomaly which is not life threatening, is inappropriate until such time that the benefits are shown to outweigh the risks of both the procedure itself and preterm delivery. Further animal studies will be needed before intrauterine surgery for humans should be considered. For the better understanding of recent techniques and complications associated with fetal intervention of congenital facial defect patients, we reviewed recent related articles about the current knowledge and new perspectives of experimental fetal fetal surgery in the cleft lip and palate defects.

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Current Status(1994) of Neonatal Surgery in Korea -Survey among the members of Korean Association of Pediatric Surgeons- (1994년도 한국신생아외과의 현황 - 대한소아외과학회 회원대상 전국조사 -)

  • Kim, W.K.;Kim, S.Y.;Kim, S.K.;Kim, I.K.;Kim, J.C.;Park, K.W.;Park, Y.S.;Park, W.H.;Park, J.S.;Song, Y.T.;Oh, S.M.;Lee, D.S.;Lee, M.D.;Lee, S.C.;Chang, S.I.;Chung, E.S.;Jung, P.M.;Joo, J.S.;Choi, S.O.;Huh, Y.S.;Hwang, E.H.
    • Advances in pediatric surgery
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    • v.2 no.1
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    • pp.26-32
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    • 1996
  • To understand the current status of neonatal surgery in Korea, a survey was made among the 27 members of Korean Association of Pediatric Surgeons. Response rate among surgeons was 78 percent, eighteen hospitals participated in this study. Five hundred and three cases of neonatal surgical patients were analyzed. In Korea, about 50% of cases were treated at the hospital in the capital city area. Regional number of patients were closely related to the regional population. Imperforate anus(19%), atresia/stenosis of gut(12%), and Hirschsprung's diseases(12%) were sitting at the top in the list. Majority of operation was done within the first week of life, especially during the first 24 hour period. Eighty per cent was major or so called index cases. Mortality in so-called index cases was 17%. High mortality was observed in patients with diaphragmatic hernia(47%), gastrointestinal perforation(65%) and esophageal atresia(28%). Low birth weight babies showed higher mortality in gastrointestinal perforation, esophageal atresia and abdominal wall defect. These were compared to 1993 survey of Japanese Society of Pediatric Surgeons.

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