Gastric surgery is one of the most frequently performed operations in Korea. Retroanastomotic hernia is a rare complication ingastric surgery. We experienced this hernia and herein report it with a review of the literature. A 69-year-old male patient suffered from periumbilical pain for 3 days. Positive physical findings were tenderness around the umbilicus and decreased bowel sound. Simple abdominal findings revealed a mechanical obstruction. This patient had a history of gastrectomy 13 years prior to admission. At operation field, we were able to find the defect consisting of the transverse mesocolon, stomach, jejunum and retroperituneum. In Korea, since its first report by Petersen, only a few reports about this hernia have been reported. After increased incidence of operations for morbid obesity, reports on retroanstomotic hernia have increased.
Aged ; Gastrectomy ; Hernia ; Humans ; Incidence ; Jejunum ; Korea ; Male ; Mesocolon ; Obesity, Morbid ; Stomach ; Umbilicus

PURPOSE: The purpose of this study is to evaluate the therapeutic efficacy, on the basis of CT findings, of high dose methyl prednisolone for treating acute lung injury that was induced by oleic acid injection. MATERIALS AND METHODS: A total of 30 healthy rabbits (1.8-2.2 kg) were included in this study. Group I included 10 rabbits in which 0.2 mL oleic acid was injected through their ear veins. Group IIa included 10 rabbits in which 30 mg/kg methyl prednisolone and 0.2 mL oleic acid were intravenously injected at the same time. Group IIb included 5 rabbits in which 30 mg/kg methyl prednisolone was injected 6 hours prior to the 0.2 mL oleic acid intravenous injection. The other 5 rabbits (Group III) were injected intravenously with 30 mg/kg methyl prednisolone without the oleic acid. After that, 30 mg/kg methyl prednisolone per every 12 hours was injected in the non-sacrificed rabbits of Group II and Group III. Nonenhanced Chest CT scans were performed prior to and 30 minutes, 4 hours, 24 hours, 48 hours, and 72 hours after the intravenous injection of oleic acid or methyl prednisolone. We randomly sacrificed one rabbit of groups I, II and III 30 minutes, 4 hours, 24 hours, 48 hours and 72 hours after CT scanning. The distribution, extent, and pattern of the lesions on the CT scan were analyzed. The analyzed pattern of the lesions was ground glass attenuation, consolidation and interstitial thickening. Pathologic correlation was then done. RESULTS: The main CT findings of Group I were peripheral, wedge shaped, ill-defined ground glass attenuations and/or consolidations. The pathologic findings of Group I were interstitial or intraalveolar edema, intraalveolar hemorrhage and coagulation necrosis. Diffuse ground glass opacities with interstitial thickening were noted in 20% (n=2/10) of Group I and in 60% (n=9/15) of Group II at the 30 minute CT; however, there was no statistical difference between the two groups (p=0.09). Consolidations with air bronchogram were noted in 22.2% (2/9) of Group I and in 38.5% (5/13) of Group II at the 4 hour CT. The main pathologic findings of consolidations were intraalveolar hemorrhage and coagulation necrosis. There was no statistical difference in the extent of the lesions between Group I and Group II (p=0.20, 0.14, 0.59 and 0.46 at 4, 24, 48 and 72 hours, respectively). The CT findings of Group IIa and Group IIb were not significantly difference. The CT findings of Group III were normal in all 5 rabbits. CONCLUSION: Because there was no significant difference for the extent of lung injury induced by oleic acid between the group treated with high dose methyl prednisolone and non-treated group on CT scans, high dose steroid therapy for acute respiratory distress syndrome and pulmonary fat embolism may not be effective in the acute stage.
Acute Lung Injury ; Ear ; Edema ; Embolism, Fat ; Glass ; Hemorrhage ; Injections, Intravenous ; Lung Injury* ; Lung* ; Necrosis ; Oleic Acid ; Prednisolone ; Rabbits* ; Respiratory Distress Syndrome, Adult ; Steroids* ; Tomography, X-Ray Computed ; Veins

No abstract available.
Nucleolus Organizer Region* ; Proliferating Cell Nuclear Antigen*

No abstract available.
Nucleolus Organizer Region* ; Proliferating Cell Nuclear Antigen*

PURPOSE: Gum chewing activates chephalic-vagal reflex as in food consumption and increases the release of gastrointestinal hormones which are related with gut motility. The objective of this study was to assess whether it is effective in shortening the time of hospitalization and postoperative ileus. METHODS: Twenty patients who received open abdominal surgery for colon cancer in Gachon University, Gil Hospital were collected. They were further categorized to gum-chewing group (n=10, mean age=52.0 years, range 37 to 70) and control group (n=10, mean age=59.7 years, range 35 to 75) randomly. The patients in the gum-chewing group chewed gum three times a day from the first postoperative AM until the day they began oral intake. The time of gas out was recorded in each group. RESULTS: The mean time of gas out were 2.35 days (SD 1.2) in gum-chewing group and 2.87 days (SD 1.2) in control group (P=0.41). The mean postoperative hospital days were 10.5 days in gum-chewing group and 13.0 days in control group (P=0.23). CONCLUSION: There were no statistically significant results for shortnening of postoperative ileus and hospital day in this study.
Colonic Neoplasms ; Gastrointestinal Hormones ; Gingiva ; Hospitalization ; Humans ; Ileus ; Mastication ; Reflex

Traumatic abdominal wall hernia after blunt abdominal trauma is rare. The prevalence of traumatic abdominal wall hernia in published series is approximately 1%. Recently, by the use of computed tomography has increased the number of occult traumatic abdominal wall hernias (TAWH). A 47-year-old woman presented to the emergency room soon after a traffic accident. She was fully conscious and complained of diffuse, dull, abdominal pain. She had a seat belt on at the time of the accident. Initial computed tomography showed that the lower left abdominal wall had a defect and that a part of the small bowel had herniated through the defect. During the operation, we made an incision at the defect site and confirmed the defect. The defect size was about 15x5 cm. The muscle layers were repaired in layers with absorbable sutures. Prolen mesh was layed down and fixed on the site of the repaired muscle defect. After 6 months, hernia had not recurred, and no weakness of the repaired abdominal wall layers was identified. The patient`s postoperative body functions were normal.
Abdominal Pain ; Abdominal Wall ; Accidents, Traffic ; Emergencies ; Female ; Hernia ; Humans ; Middle Aged ; Muscles ; Prevalence ; Seat Belts ; Sutures

Early CT findings of transient radiographic progression (TRP) during treatment of active pulmonary tuberculosis including subpleural, interlobular or intralobular septal thickening and micronodules are shown in the present case. Late CT findings of TRP are subpleural, enhancing nodular infiltration with internal low attenuation. These CT features accompanied by a lack of clinical worsening in young patients taking antituberculous medication due to pulmonary tuberculosis can help to differentiate TRP from other disease entities.
Humans ; Lung ; Tuberculosis ; Tuberculosis, Pulmonary

No abstract available.
Diagnosis ; Ductus Arteriosus, Patent ; Endarteritis ; Pulmonary Embolism

Core decompression is still widely used in avascular necrosis of the femoral head but the results are unpredictable and the indications are not settled yet. The reparative process of the decompressed femoral head is poorly understood. Seven cases in 5 patients were undertaken THRA following failed decompression and these were studied for the radiological and pathological changes of the core tracts. The lesions of failed cases were involved more than 1/3 of femoral head on MRI and all cases were stage II A or B. The extent of the necrotic area in MRI was enlarged with crack, sclerosis and sometimes gas collection. Depression of the subchondral plates were also observed. Capillary ingrowth or neovascularization was not found at all and there were only fibrosis, inflammatory response and foreign body reactions.
Capillaries ; Decompression* ; Depression ; Fibrosis ; Foreign Bodies ; Head* ; Humans ; Magnetic Resonance Imaging ; Necrosis* ; Sclerosis