• Journal of Chest Surgery
• /
• v.24 no.12
• /
• pp.1238-1241
• /
• 1991

Agenesis of the hemidiaphragm is unusual congenital anomaly associated with a high mortality. A case of congenital agenesis of left diaphragm was experienced in 22-day old male patient who was dyspneic and cyanotic on admission. Emergency exploration through the left eight interspace thoracotomy showed complete agenesis of the left diaphragm. The stomach and transverse colon covered with peritoneal sac was partially herniated into left hemithorax. The left lung was slightly hypoplastic. This neonate had no intestinal malrotation. The defect was reconstructed using Dacron graft. Dacron patch was sutured with interrupted Ethibond to chest wall anteriorly, esophagus aorta and costomediastinal sinus medially, and the tenth rib posterolaterally. Postoperatively, Extubation was performed at 1st day, but some respiratory difficulty was noted. Severe dyspnea was occurred at postoperative 11th day and so reintubation was done. Intermittently ventilatory support and intravenous alimentation were continued for 9 days after that. Thereafter he had no respiratory problems at discharge.

• Journal of Korean Neurosurgical Society
• /
• v.44 no.4
• /
• pp.240-244
• /
• 2008

Objective : Sotos Syndrome is characterized by macrocephaly, overgrowth, and developmental delay, and more than 300 patients have been reported worldwide to date. The authors reviewed the clinical characteristics of 8 patients with Sotos Syndrome in Korea for a new understanding and treatment strategies. Methods : The medical records of a total of eight Korean children with Sotos Syndrome were reviewed. All patients underwent developmental checkup, lumbar punctures for measurement of intracranial pressure (ICP), brain and spine magnetic resonance imaging and computerized tomography. Results : All 8 patients showed macrocephaly and the characteristic craniofacial features of Sotos Syndrome. Other clinical characteristics shown were overgrowth (7/8), developmental delay (7/8), congenital heart defect (3/8), flat foot (8/8), scoliosis (4/8), spina bifida (8/8), hydrocephalus (4/8), cavum vergae (3/8), and increased subdural fluid collection (5/8). Mean ICP measured via lumbar puncture was $27.35{\pm}6.25\;cm$ $H_2O$ (range 20 to 36 cm $H_2O$). Two patients received ventriculo-peritoneal shunt, and 1 patient underwent subduro-peritoneal shunt with improvement. Spinal orthosis was applied to 4/5 patients with scoliosis and 4/8 children with flat foot were provided with foot orthosis. Conclusion : In this first Korean study of 8 Sotos Syndrome patients we demonstrated the presence of spina bifida and increased ICP, which had not been previously described. The authors therefore suggest that all patients with Sotos Syndrome should undergo examination for the presence of spina bifida, and that shunt procedures would improve development and alleviate clinical symptoms.

• Clinical and Experimental Reproductive Medicine
• /
• v.12 no.1
• /
• pp.47-70
• /
• 1985

This study was presented of the 1,872 cases of infertile couples who visited and examined at the sterility clinic of Department of Obstetrics & Gynecology, Seoul National University Hospital from Sept., 1980 to Dec., 1983. Age, duration of infertility, past medical history, and other general factors were analyzed, and the factors responsible for infertility were classified and discussed. Mode of treatment, outcome of pregnancy, pregnancy rate responsible for each factor were also presented. The results were as follows: 1) The infertility was primary in 1,128, or 60.3% and secondary in 744, or 39.7%. 2) The age between 26 and 30 years of age comprised about one half of the total patients. 3) The duration of infertility between 1 and 4 years comprised about three quarters of the total patients, and the mean duration was 3.8 years. 4) The most common medical history in primary infertility was tuberculous disease, and that in secondary infertility was history of previous laparotomy. 5) About two thirds of antecedent pregnancies were abortion. 6) The major etiologic factor of infertility were male factor in 12.3%, tubal factor in 38.8%, ovulatory failure in 25.4%, uterine factor in 8.8%, cervical factor in 5.2%, peritoneal factor in 9.5%, and no demonstrable cause in 11.3%. 7) The types of male factor were azoospermia in 61.6%, oligospermia in 25.8%, low motility in 11.6%, and other abnormality in 1.0%. 8) The types of ovulatory failure were ovarian failure in 7.4%, hypothalamo-pituitary failure in 8.1 %, hypothalamo-pituitary dysfunction (including Polycystic ovarian syndrome) in 30.2%, and hyperprolactinemia in 22.4%. 9) The types of uterine factor were endometrial tuberculosis in 27.5%, uterine synechia in 33.8%, uterine anomaly in 19.7%, myoma and polyp in 9.1 %, and luteal phase defect in 9.9%. 10) The types of peritoneal factor were pelvic adhesion in 80.9% and endometriosis in 19.6%. 11) Surgeries were done in 408 patients, and they were salpingolysis, lysis of extraadnexal adhesion, salpingostomy, fimbrioplasty, ovarian wedge resection for polycystic ovarian disease, tubo-tubal anastomosis, and tubo-uterine implantation in orders. 12) 243 pregnancies were achieved during the infertility work-up, of which livebirth was 46.5%, ectopic pregnancy was 7.4%, spontaneous abortion was 7.8%, and on-going pregnancy or lost to follow-up was 36.2%. 13) Pregnancy rates in various factors were male factor in 18.7%, ovulatory factor in 31.7%, tubal factor in 24.2%, uterine factor in 34.6%, cervical factor in 19.0%, peritoneal factor in 29.0%, combined factors in 10.5%, and unexplained infertility in 37.1%. Pregnancy rate in whole patients was 25.2%.

• Archives of Plastic Surgery
• /
• v.38 no.5
• /
• pp.655-662
• /
• 2011

Purpose: The anterolateral thigh flap is versatile flap for soft-tissue reconstruction for defects located at various sites of the body. This useful flap offers a thick and vascular fascia lata component with large amounts that can be soft tissue coverage for different reconstructive purposes. We present our clinical experience with the use of vascular fascia lata, combined with anterolateral thigh flap for various reconstructive goals. Methods: From April 2008 to February 2011, we transferred anterolateral thigh flaps with fascia lata component to reconstruct soft-tissue defects for different purposes in 11 patients. The fascia lata component of the flap was used for tendon gliding surface in hand/forearm reconstruction in 4 patients, for reconstruction medial and lateral patellar synovial membrane and retinaculum in 2 patients, for reconstruction of plantar aponeurosis in the foot in 2 patients, for reconstruction of fascial and peritoneal defect in the abdominal wall in 2 patient, and for dural defect reconstruction in the scalp in the remaining one. Results: Complete loss of the flap was not seen in all cases. Partial flap necrosis occurred in 2 patients. These complications were treated successfully with minimal surgical debridement and dressing. Infection occurred in 1 patient. In this case, intravenous antibiotics treatment was effective. Conclusion: Anterolateral thigh flap has thick vascular fascia with large amounts. This fascial component of the flap is useful for different reconstructive aims, such as for tendon, ligament, aponeurosis defects, abdominal wall or dura reconstruction. It should be considerated as an important advantage of the flap, together with other well-known advantages.

• Proceedings of the Korean Society of Veterinary Clinics Conference
• /
• 2007.05a
• /
• pp.151-151
• /
• 2007

• Journal of Chest Surgery
• /
• v.6 no.1
• /
• pp.109-112
• /
• 1973

Bochdalek hernia is the most common congenital diaphragmatic hernia and that of the foramen of Bochdalek is rare in right side of the diaphragm. Two cases of right Bochdalek hernia were reported in literatures published in Korea. The first case was associated with hypoplasia of the lung and could not be survived. The second case [four months old male infant] was operated on August 28, 1971. at Ewha University Hospital arid survived. The third case was a three months old male infant who had been born at 8th lunar month in a private clinic. During the period of three months prior to admission this premature infant was suf-fered from mild respiratory distress measured as pneumonia. On December 20. 1972, this infant was admitted at Kyung Hee University Hospital with severe respiratory distress developed abruptly. Chest X-ray examination [barium study] demonstrated right diaphragmatic hernia. Right hemithorax was filled with intestines and right lobe of the liver which were repositioned back into the peritoneal cavity through the foramen of Bochdalek. 3. 0 cm x3.5 cm in size, and the defect was closed with interrupt mattress sutures. There was hypospadia with chordee but no other associated anomalies such as hypoplasia of the lung, malrotation or malfixation of intestines, and cardiovascular anomalies. The Postoperative hospital course was not eventful and the baby was discharged on the 14th postoperative day.

• Toxicological Research
• /
• v.11 no.1
• /
• pp.15-21
• /
• 1995

Several populations of lymphocytes possess receptors for autonomic neurotransmitter, which make lymphocytes susceptible to autonomic stimulation. This study was to evaluate the functional alternation of effector cells of the immune system. Female Balb/C mice, 15-20 g, were injected with MA subcutaneously under various conditions. Mixed lymphocyte reaction (MLR) showed certain T cell subsets were affected by MA. The level of interleukin-2 (IL-2) production was inhibited due to a defect in expression of the IL-2 receptor. In mice injected with 20 mg MA/kg, 1 day before assay, phagocytosis of peritoneal macrophages showed $14.07\pm3%$, which was similar degree to 5 mg MA/kg treatment for 4 consecutive days. Phagocytosis was almost recovered to that of control after 4 day in 20 mg/kg injected mice. Maximum inhibition of plaque forming cell (PFC) occurred when MA was given early, indicating the inductive time point of antibody production was affected. The cortisol level increased in the MA treated group (0.05, 0.20, and $0.08{\mu}g$/dl for control, low, and high dose-MA treated mice, respectively). Based on these results, MA has general suppression effects on the immune systems by functional alteration of effector cells. Considering the increment of serum cortisol levels, MA partially impacts the neuroendocrine system to lead to failure of immune response.

• Neonatal Medicine
• /
• v.17 no.2
• /
• pp.254-261
• /
• 2010

Little is known about neonatal mitochondrial disease, though mitochondrial metabolic disorders may often present in the neonatal period because of the high energy requirement of neonate. In newborn period, common presentations are not specific and the disease course may be rapid and fatal. In this study, we report three cases of neonatal mitochondrial disease. The first case was strongly suspected because of sudden seizure and mental change with severe lactic acidosis, and multiorgan failure. Plasma lactate/pyruvate (L/P) ratio was increased to 55.6 with marked lactic aciduria and increased plasma alanin up to 2,237 nmol/mL. In the second patient, a peritoneal dialysis was performed for acute adrenal and renal failure, but metabolic acidosis persisted. Plasma L/P ratio was increased to 23.9, and MRC I (mitochondrial respiratory chain defect) was diagnosed through the enzymatic analysis of the muscles. The third case showed repetitive episode of lactic acidosis during the first two months of life, hypotonia, failure to thrive and feeding difficulties. We found markedly increased cerebrospinal fluid L/P ratio up to 57 though plasma L/P ratio(19.4) was borderline with increased plasma lactate. The lactate peak was prominent in brain magnetic resonance spectroscopy (MRS). MRC II was confirmed through muscle biopsy. Plasma lactate level and lactate peak of brain MRS were normalized after conservative treatment.

• Journal of Veterinary Clinics
• /
• v.27 no.5
• /
• pp.600-604
• /
• 2010

A ten-year-old female mongrel dog was presented to Veterinary Medical Center, Chungbuk National University with the signs of anorexia, weakness, and hemoglobinuria. Patient had been diagnosed as dirofilariasis based on heartworm antigen test and treated with adulticide (melarsomine) at local hospital one day before admission. On laboratory examinations, there were hypochromic and microcytic regenerative anemia, thrombocytopenia, moderate neutrophilia, and increase ALT, AST, and ALP. Radiographic exam showed main pulmonary artery bulging, pulmonary infiltration and hypervascularity, reduced abdominal serosal detail and mild hepatomegaly. Abdominal ultrasonographic exam showed mild peritoneal effusion and large hyperechoic thrombi at trifurcation of the porta hepatica and the splenic vein. In addition, intraluminal low density area and intravascular filling defect were confirmed on contrast enhanced CT scanning at the same anatomic locations. Patient was treated with anticoagulant and thrombolytic therapy. On day 42 after treatment, complete resolution of thrombi was confirmed via ultrasonography and improvement of clinical signs was observed.

• Journal of Chest Surgery
• /
• v.29 no.8
• /
• pp.828-835
• /
• 1996

From January 1993 to April 1995, 27 neonates (under age of 30 days underwent open heart surgery in the Department of Thoracic and Cardiovascular Surgery, Dong-A Medical Center. Mean age and weight were 12.1 days(2days∼306ays) and 3.29 kg(2.6kg∼4.1 kg) respectively. Cardiac anomalies were simple complete transposition of great arteries(TGA) in 11 neonates, TGA with coarctation of aorta(COA) in 1 , total anomalous pulmonary venous connection(TAPVC) in 5, double inlet right ventricle with TAPVC in 1, interrupted aortic arch(IAA) with ventricular septal defect(VSD) in 3, pulmonary atresia(PA) with intact ventricular septum(IVS) in 3, pulmonary stenosis with IVS in 1, Taussig-Bing anomaly with IAA in 1, and hypoplastic left heart syndrome(HLHS) in 1 . Postoperative complications were myocardial and/or pulmonary edema which caused open sternum in 13 patients(54.2%), acute renal failure( RF) in 10(37.0%), Intractable low cardiac output syndrome (LCOS) including weaning failure from cardiopulmonary bypass in 7(25.9%), bronchopulmonary dysplasia in 1, wound infection in 1, and paroxysmal supraventricular tachycardia in 1. Nine of 13 patients with postoperative open sternum were recovered with delayed sternal closure, and seven of 10 patients survived postoperative ARF with peritoneal dialysis. There were 8 operative deaths(29.6%): 3 in the patients with simple complete TGA, 1 In TCA with COA, 1 in PA with IVS, 1 in Taussig-Bing anomaly with IAA, 1 in DIRV with TAPVC, and 1 in HLHS. One late death occurred after arterial switch operation in simple TGA. The mosts common cause of death was low cardiac output syndrome. Our initial experience of open heart surgery in neonates showed high operative mortality and morbidity, especially in complex anomalies.