• Title/Summary/Keyword: Lateral mass

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A Gunshot Wounds to the Cervical Spine and the Cervical Spinal Cord: A Case Report (총상으로 인한 경추부 및 척수손상: 증례 보고)

  • Paeng, Sung Hwa
    • Journal of Trauma and Injury
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    • v.25 no.2
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    • pp.57-62
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    • 2012
  • Gunshot wounds are rare in Korea, but they have tended to increase recently. We experienced an interesting case of penetrating gunshot injuries to the cervical spine with migration the fragments of the bullet within the dural sac of the cervical spine, so discuss the pathomechanics, treatment and complications of gunshot wounds to the spine and present a review of the literature. A 38-year-old man who had tried to commit suicide with a gun was admitted to our hospital with a penetrating injury to the anterior neck. the patient had quadriplegia. A Computed tomography (CT) scan and 3-dimensional CT of the spine showed destruction of the left lateral mass and lamina of the 5th cervical vertebra; the bullet and fragments were found at the level of the 5th cervical vertebra. The posterior approach was done. A total laminectomy and removal of the lateral mass of the 5th cervical vertebrae were performed, and bone fragments and pellets were removed from the spinal canal, but an intradurally retained pellets were not totally removed. A dural laceration was noted intraoperatively, and CSF leakage was observed, so dura repair was done watertightly with prolene 6-0. The dura repair site was covered with fibrin glue and Tachocomb$^{(R)}$. Immediately, a lumbar drain was done. Radiographs included a postoperative CT scan and X-rays. The postoperative neurological status of the patient was improved compared with the preoperative neurological status. however, the patients developed symptoms of menigitis. He received lumbar drainage(200~250 cc/day) and ventilator care. After two weeks, panperitonitis due to duodenal ulcer perforation was identified. Finally, the patient died because of sepsis.

Comparison of Outcomes after Atlantoaxial Fusion with Transarticular Screws and Screw-Rod Constructs

  • Kim, Ji Yong;Oh, Chang Hyun;Yoon, Seung Hwan;Park, Hyeong-Chun;Seo, Hyun Sung
    • Journal of Korean Neurosurgical Society
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    • v.55 no.5
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    • pp.255-260
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    • 2014
  • Objective : The purpose of this study was to compare the radiological and neurological outcomes between two atlantoaxial fusion method for atlantoaxial stabilization; C1 lateral mass-C2 pedicle screws (screw-rod constructs, SRC) versus C1-2 transarticular screws (TAS). Methods : Forty-one patients in whom atlantoaxial instability was treated with atlantoaxial fixation by SRC group (27 patients, from March 2005 to May 2011) or TAS group (14 patients, from May 2000 to December 2005) were retrospectively reviewed. Numeric rating scale (NRS) for pain assessment, Oswestry disability index (ODI), and Frankel grade were also checked for neurological outcome. In radiologic outcome assessment, proper screw position and fusion rate were checked. Perioperative parameters such as blood loss during operation, operation time, and radiation exposure time were also reviewed. Results : The improvement of NRS and ODI were not different between both groups significantly. Good to excellent response in Frankel grade is shown similarly in both groups. Proper screw position and fusion rate were also observed similarly between two groups. Total bleeding amount during operation is lesser in SRC group than TAS group, but not significantly (p=0.06). Operation time and X-ray exposure time were shorter in SRC group than in TAS group (all p<0.001). Conclusion : Both TAS and SRC could be selected as safe and effective treatment options for C1-2 instability. But the perioperative result, which is technical demanding and X-ray exposure might be expected better in SRC group compared to TAS group.

Analysis of Posterior Cervical Fixation and Fusion in Subaxial Cervical Spine Injury (중하부 경추손상에서 후방 경추 내고정술 및 골유합술의 분석결과)

  • Lee, Dong Hoon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.30 no.12
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    • pp.1388-1393
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    • 2001
  • Objective : In the retrospective analyzing 19 consecutive patients with subaxial cervical spine(C3~T1) injury treated by posterior cervical fixation and fusion, clinical manifestation, radiologic finding, operative technique, and postoperative results following 6 months were analyzed. Materials and Methods : Most common fracture level was C4-5, mean age 41, and male to female ratio 13 : 6. The most common cause of injury was motor vehicle accident(17 cases). In 19 cervical procedures, interspinous triple wiring was done in 14 cases, lateral mass plating in 5 cases, and additional anterior fusion in 2 cases. Results : Twelve weeks after operation, all cases were reviewed by plain cervical radiogram. In 17 cases that treated by posterior fusion only, 14 cases(81%) had kyphotic angle change less than $5^{\circ}$, 2 cases(12%) $5-20^{\circ}$, and 1 case(6%) more than $20^{\circ}$. Overall fusion rate was 88%, and there was no significant difference of bone fusion rate between autogenous bone graft and allogenous bone graft. Conclusion : In the case of severe posterior column injury or displacement, posterior approach seems superior to anterior approach, but in the case of combined anterior column injury, anterior approach is considered necessary. In this study, posterior fixation and fusion might be acceptable procedure for subaxial cervical fracture and dislocation, owing to its high fusion rate, low kyphotic angulation and low operation related complication rate.

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A Study of Hydrodynamic Forces Acting on a Ship Hull Under Lateral Low Speed Motion (저속 횡 이동하는 선박의 선체에 작용하는 유체력에 관한 연구)

  • 이윤석;김순갑
    • Journal of the Korean Institute of Navigation
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    • v.23 no.2
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    • pp.29-42
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    • 1999
  • An accurate method of estimating ship maneuverability needs to be developed to evaluate precisely and improve the maneuverability of ships according to the water depth. In order to estimate maneuverability by a mathematical model. The hydrodynamic forces acting on a ship hull and the flow field around the ship in maneuvering motion need to be estimated. The ship speed new the berth is very low and the fluid flow around a ship hull is unsteady. So, the transient fluid motion should be considered to estimate the drag force acting on the ship hull. In the low speed and short time lateral motion, the vorticity is created by the body and grow up in the acceleration stage and the velocity induced by the vorticity affect to the body in deceleration stage. For this kind of problem, CFD is considered as a goof tool to understand the phenomena. In this paper, the 2D CFD code is used for basic consideration of the phenomena to solve the flow in the cross section of the ship considering the ship is slender and the water depth is large enough. The flow fields Added and hydrodynamic forces for the some prescribed motions are computed and compared with the preliminary experiment results. The comparison of the force with measurement is shown a fairly good agreement in tendency. The 3D Potential Calculation based on the Hess & Smith Theory is employed to predict the surge, sway added mass and yaw added moment of inertia of hydrodynamic coefficients for M/V ESSO OSAKA according to the water depth. The results are also compared with experimental data. Finally, the sway added mass of hydrodynamic coefficients for T/S HANNARA is suggested in each water depth.

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Usefulness of Oncoplastic Volume Replacement Techniques after Breast Conserving Surgery in Small to Moderate-sized Breasts

  • Yang, Jung Dug;Kim, Min Chul;Lee, Jeong Woo;Cho, Young Kyoo;Choi, Kang Young;Chung, Ho Yun;Cho, Byung Chae;Park, Ho Yong
    • Archives of Plastic Surgery
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    • v.39 no.5
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    • pp.489-496
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    • 2012
  • Background In Korean women, many of whom have small to moderate-sized breasts, it is difficult to cover a partial breast defect using oncoplastic volume displacement techniques after removal of an adequate volume of tissue during oncologic surgery. In such cases, oncoplastic volume replacement techniques are more useful. Methods From January 2007 to December 2011, 104 women underwent a total of 107 breast-conserving surgeries with various kinds of oncoplastic volume replacement techniques. We used latissimus dorsi (LD) myocutaneous flap for cases in which the resection mass was greater than 150 g. In case with a resection mass less than 150 g, we used regional flaps such as a lateral thoracodorsal flap, a thoracoepigastric flap, or perforator flaps such as an intercostal artery perforator (ICAP) flap or a thoracodorsal artery perforator (TDAP) flap. Results The mean age was 46.1 years, and the average follow-up interval was 10.3 months. The patients underwent oncoplastic volume replacement techniques with a lateral thoracodorsal flap (n=9), thoracoepigastric flap (n=7), ICAP flap (n=25), TDAP flap (n=12), and LD flap (n=54). There was one case of congestion in an LD flap, and two cases of fat necrosis in an ICAP flap. Most of the patients were satisfied with the cosmetic results. Conclusions Oncoplastic volume replacement techniques can be reliable and useful for the correction of breast deformity after breast-conserving surgery, especially in patients with small to moderate-sized breasts.

Numerical estimation for safety factors of tunnels considering the failure of supports (지보재 파괴를 고려한 터널 안전율의 수치해석적 산정 연구)

  • You, Kwang-Ho;Park, Yeon-Jun;Hong, Keun-Young;Lee, Hyun-Koo;Kim, Jea-Kwon
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.7 no.1
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    • pp.37-49
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    • 2005
  • In a tunnel, failure of its supports can cause failure of the tunnel. Therefore it is important to estimate safety factor of the tunnel which the failure of its supports is taken into account. In previous studies, supports of tunnels were usually modelled as beam elements. The failure of the supports was decided by comparing the allowable stress and the calculated bending stresses inside the beam elements in estimating safety factor of the tunnel considering the failure of its supports. In this study, it is suggested how to model the supports properly. To this end, supports of a tunnel were modelled by both beam (elastic) elements and continuum (elasto-plastic) elements in two dimensional numerical analyses. Meanwhile, it was analyzed how rock mass class, coefficient of lateral pressure, shotcrete thickness, the existence of rock bolt, and excavation method had an effect on the safety factor of a tunnel.

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Spontaneous abdominal intramuscular hematoma in a non-dialysis chronic kidney disease patient under cilostazol therapy (투석하지 않는 만성신질환 환자에서 cilostazol 투여 중에 발생한 복벽의 자발성 근육내 혈종)

  • Kang, Seonghui;Yu, Hyung Min;Na, Ha Young;Ko, Young Kyung;Kwon, Se Woong;Lim, Chae Ho;Kim, Sun Woong;Jo, Young Il
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.139-143
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    • 2014
  • Spontaneous intramuscular hematoma of the abdominal wall is a rare condition characterized by acute abdominal pain. It is often misdiagnosed as a surgical condition. It used to be associated with risk factors such as coughing, pregnancy, and anticoagulant therapy. Most cases of abdominal wall hematomas were rectus sheath hematomas caused by the rupture of either the superior or inferior epigastric artery, but spontaneous internal oblique hematoma was extremely rare. In this report, we present a case of spontaneous internal oblique hematoma in a 69-year-old man with non-dialysis chronic kidney disease who was taking cilostazol. The patient complained of abrupt abdominal pain with a painful palpable lateral abdominal mass while sleeping. The abdominal computed tomography showed an 8 cm-sized mass in the patient's left internal oblique muscle. The administration of cilostazol was immediately stopped, and the intramuscular hematoma of the lateral oblique muscle disappeared with conservative management.

INFLUENCE OF HEATED SPREADER ON THE SEALING ABILITY OF LATERAL CONDENSATION (측방가압충전시 Heated Spreader 사용유무가 근관밀폐에 미치는 영향)

  • Chung, Won-Gyun;Hong, Chan-Ui
    • Restorative Dentistry and Endodontics
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    • v.24 no.1
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    • pp.222-232
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    • 1999
  • The purpose of this study was to evaluate the effect of heated spreader on the sealing ability of lateral condensation, compared with regular cold spreader. Forty two extracted human teeth with single canal were randomly placed into 3 experimental groups, and four additional teeth were used as positive and negative controls. Each group was prepared with Ni-Ti Profile #40 using step-down technique and obturated with standardized colored gutta-percha cone by standard(cold) lateral condensation technique, warm lateral condensation technique with Endotec and hot spreader soaked in glass bead sterilizer, each with Sealapex sealer. Control groups were not obturated, but prepared. After 2 days in 2% methylene blue, the teeth were invested and made into transparent resin blocks. And then, each block was sectioned horizontally with microtome at 1, 2, 3, 4, 5 mm levels from the apex. The linear extent of dye penetration was examined with stereomicroscope at ${\times}$20 magnification. At each of 5 levels, ratio of the area of gutta-percha was obtained by calculating the area of gutta-percha to the total area of the canal. The data collected were then analyzed statistically using an analysis of variance(ANOVA) and Scheffe test. The results were as follows ; 1. All experimental groups produced the apical microleakage. 2. The mean leakage was 1.57${\pm}$0.76mm for cold spreader group, 0.86${\pm}$0.95mm for Endotec spreader group, and 0.64${\pm}$0.93mm for hot spreader group. The difference between hot spreader group and cold spreader group was statistically significant(p<0.05). 1. At the 1 mm level, the mean ratio of area of gutta-percha was 74.58${\pm}$13.15(%) for cold spreader group, 65.42${\pm}$14.62(%) for Endotec spreader group, and 80.72${\pm}$14.63(%) for hot spreader group. There was statistically significant difference between hot spreader group and Endotec spreader group(p<0.05). 2. At the 2mm level, the mean ratio of area of gutta-percha was 87.86${\pm}$11.22(%) for cold spreader group, 66.55${\pm}$14.02(%) for Endotec spreader group, and 92.93${\pm}$7.24(%) for hot spreader group. There was statistically significant difference between Endotec spreader group and other two spreader groups(p<0.05). 3. At the level 3, 4, 5 mm, there was no statistically significant difference between each group. Within the limits of the results of this experiment, warm lateral condensation technique with hot spreader soaked in a glass bead sterilizer demonstrated favorable apical sealing effect and improved density of gutta-percha mass. Thus, it is thought that this obturation technique is effective for clinical use and beneficial to reduce condensation forces, also economical and easy. Lateral condensation, Heated spreader, canal sealing, Microleakage.

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Spontaneously Occurring Chemodectoma in a Yorkshire Terrier Dog

  • Park, Chul;Yoo, Jong-Hyun;Kim, Dae-Young;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.25 no.3
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    • pp.187-191
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    • 2008
  • A 7-year-old, intact female Yorkshire terrier dog was presented for coughing, anorexia, chest pain and dyspnea. Right lateral thoracic radiograph demonstrated a large mass shape on the heart base with decreased cardiac silhouette and severe right deviation of the trachea with the heart shifted to the left thoracic wall was observed on the ventrodorsal thoracic projection. Echocardiographic examination revealed a large rounded mass compressing left atrium around the heart base without signs of pericardial effusion. On computed tomographic (CT) findings, sagittal CT images depicted the possibility of cranial vena caval invasion and heart base involvement of the mass associated with biatrial compression. Dorsal CT image revealed the right deviation of trachea due to the heart base mass and markedly shrunk lung space was detected on the transverse CT image. Because the dog suddenly had died during the recovery from anesthesia after finishing CT scan, necropsy was performed. On gross findings, a large and lobulated mass was located at the base of the heart. A poorly-demarcated, infiltrative, multilobulated tumor composed of polyhedral cells in solid cellular sheets was confirmed based on histopathologic examination. This dog was diagnosed as a chemodectoma. This case report describes the clinical findings, diagnostic consistency of thoracic radiography, echocardiography and CT, and histopathologic confirmation in a spontaneously occurring chemodectoma with a Yorkshire terrier dog.

Malignant Fibrous Histiocytoma of the Lung - A case report - (폐 악성 섬유성 조직구종 -1예 보고 -)

  • Kim, Dae-Hyun;Kim, Jung-Heon;Kim, Bum-Shik;Park, Joo-Chul
    • Journal of Chest Surgery
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    • v.40 no.11
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    • pp.786-788
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    • 2007
  • Primary malignant fibrous histiocytoma of the lung is extremely rare, A 12-year-old child was admitted to the hospital due to an incidentally detected lung mass. A $2.5{\times}2.5 cm$ sized mass located in the right lower lobe was seen on the chest X-ray, the chest computed tomogram and the positron emission tomogram. We resected the mass through a right lateral thoracotomy and the mass was revealed to be a malignant spindle cell neoplasm on the frozen section diagnosis. So, we performed lobectomy of the right lower lobe with systemic dissection of the mediastinal lymph nodes; the final histopathological diagnosis of the mass was malignant fibrous histiocytoma. The patient was discharged on postoperative day 7 and adjuvant chemotherapy was not applied.