• Title/Summary/Keyword: Ruptured

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Delayed Appearance of Radiologically Occult Cerebral Arteriovenous Malformation : A Case Report and Literature Review

  • Hangeul Park;Hyun-Seung Kang;Won-Sang Cho
    • Journal of Korean Neurosurgical Society
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    • v.66 no.2
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    • pp.199-204
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    • 2023
  • It is critical to identify the ruptured cerebral arteriovenous malformations (AVMs) for secondary prevention. However, there are rare cases unidentified on the radiological evaluation. We report on a patient with the delayed appearance of radiologically occult AVM as a probable cause of the previous intracerebral hemorrhage (ICH). An 18-year-old male patient presented with a right temporal ICH. The preoperative radiological examination did not reveal any causative lesions. Because of the intraoperative findings suggesting an AVM, however, only hematoma was evacuated. Disappointedly, there were no abnormal findings on postoperative and follow-up radiographic examinations. Eleven years later, the patient presented with an epileptic seizure, and an AVM was identified in the right temporal lobe where ICH had occurred before. The patient underwent partial glue embolization followed by total surgical resection of the AVM and anterior temporal lobe. Based on the literature review published in the era of magnetic resonance imaging, common clinical presentation of radiologically occult AVMs included headache and seizure. Most of them were confirmed by pathologic examination after surgery. In cases of the ICH of unknown etiology in young patients, long-term follow-up should be considered.

A Study on the Iodine-induced Stress Corrosion Cracking of Zircaloy-4 Cladding (I) (지르칼로이-4 피복재의 요드응력 부식 균열에 대한 연구)

  • Ryu, W.S.;Hong, S.I.;Choi, Y.;Kang, Y.H.;Rim, C.S.
    • Nuclear Engineering and Technology
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    • v.17 no.3
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    • pp.193-199
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    • 1985
  • Iodine-induced stress corrosion cracking tests of Zircaloy-4 cladding were undertaken using the modified infernal pressurization method. The effects of iodine concentration and applied stress were studied. The critical iodine concentration for SCC was found to be about 0.2 mg/$\textrm{cm}^2$ at 603$^{\circ}$K. The threshold stress was dependent on the test temperature and the mechanical properties of the specimen. The fracture surface showed that the crack propagated stepwise iron one grain to others until the material was unstable and then ruptured mechanically. The initial region showed the transgranular feature and the wedge-shaped cracks. As the crack proceeded, the transgranular and ductile-tearing mired feature appeared in the middle region.

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Ruptured uterus in a 36-week pregnant patient with hemorrhagic shock after blunt trauma in Korea: a case report

  • Sebeom Jeon;Suyoung Park;Soohyun Oh;Jayun Cho
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.281-285
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    • 2023
  • Traumatic uterine rupture is uncommon but can be fatal and life-threatening for both the mother and infant. In addition to complications caused by trauma itself, such as pelvic fracture, gestational complications such as placental abruption, abortion, premature labor, rupture of membranes, maternal death, and stillbirth can occur. In particular, fetuses have been reported to have a high mortality rate in cases of traumatic uterine rupture. A 35-year-old pregnant female patient fell from the fourth floor and was admitted to our trauma center. We observed large hemoperitoneum, pelvic fractures, and spleen laceration, and the fetus was presumed to be located outside the uterus. The pregnant woman was hemodynamically unstable. Although the fetus was stillborn, angioembolization and surgical treatment were properly performed through collaboration with an interventional radiologist, obstetrician, and trauma surgeons. After two orthopedic operations, the patient was discharged after 34 days. This case report suggests the importance of a multidisciplinary approach in the treatment of pregnant trauma patients.

Unexpected postoperative atlantoaxial rotatory subluxation after excision of melanocytic nevi of the head and neck in older children: two case reports and literature review

  • Jiwon Kang;Byung Jun Kim
    • Archives of Craniofacial Surgery
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    • v.25 no.2
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    • pp.85-89
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    • 2024
  • Postoperative atlantoaxial rotatory subluxation (AARS) is a rare complication that develops almost exclusively in children following oropharyngeal and otologic surgeries, proposing that oropharyngeal inflammatory responses and excessive head rotation are responsible factors. However, there have been no reports of AARS after excision of a nevus on the head and neck. Here, we present two cases of AARS following limited head rotation during simple nevus excision. Patient 1, a 9-year-old girl, complained of neck pain and limited range of motion after excision of the nevus on the neck. After 2 months, computed tomography and magnetic resonance imaging finally revealed AARS with a ruptured transverse atlantal ligament. A month of halo traction was required for the treatment. Patient 2, an 11-year-old girl, presented with immediate pain and limited neck extension after tissue expander insertion under the upper chest and excision of the nevus on her left cheek. The diagnosis was promptly made using cervical spine radiography. A cervical collar was applied for 1 month. Both patients recovered without any complications after treatment. This report highlights the importance of suspicion for AARS after surgery regardless of surgical duration or amount of head rotation.

A Study on the Safety Improvement of Carbon Black Manufacturing Process (카본블랙 제조공정의 안전성 향상에 관한 연구)

  • Joo, Jong-Yul;Jeong Phil-Hoon;Sung-Eun, Lee
    • Journal of the Korea Safety Management & Science
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    • v.25 no.4
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    • pp.153-161
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    • 2023
  • Carbon black is a material in the form of fine black powder obtained by incomplete combustion or pyrolysis of hydrocarbons, and is composed of 90-99% carbon, and the rest is composed of hydrogen and oxygen. In the event of an emergency during the manufacture of carbon black, the generated tail gas should be safely discharged through an emergency line to prevent fire, explosion, and environmental pollution accidents caused by the tail gas. If the pressure continues to rise, the pressure control valve shall operate and the rupture plate shall be ruptured sequentially and the tail gas shall be discharged to the vent stack through the emergency line. As an emergency emission system, even if some untreated substances in the tail gas are released into the atmosphere, they are lighter than air, so it is safe to discharge them to a safe place through the Vent Stack. If the gas pressure is rising or worse, it is discharged from the Vent Stackine, and discharging fuel.

Tuberculous Aneurysm of the Abdominal Aorta: Endovascular Repair Using Stent Grafts in Two Cases

  • Wei Chiang Liu;Byung Kook Kwak;Kyo Nam Kim;Soon Yong Kim;Joung Joo Woo;Dong Jin Chung;Ju Hee Hong;Ho Sung Kim;Chang Jun Lee;Hyung Jin Shim
    • Korean Journal of Radiology
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    • v.1 no.4
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    • pp.215-218
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    • 2000
  • Tuberculous aneurysm of the aorta is exceedingly rare. To date, the standard therapy for mycotic aneurysm of the abdominal aorta has been surgery involving in-situ graft placement or extra-anatomic bypass surgery followed by effective anti-tuberculous medication. Only recently has the use of a stent graft in the treatment of tuberculous aortic aneurysm been described in the literature. We report two cases in which a tuberculous aneurysm of the abdominal aorta was successfully repaired using endovascular stent grafts. One case involved is a 42-year-old woman with a large suprarenal abdominal aortic aneurysm and a right psoas abscess, and the other, a 41-year-old man in whom an abdominal aortic aneurysm ruptured during surgical drainage of a psoas abscess.

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A case of delayed hemorrhage of a subcapsular liver hematoma in a neonate (신생아에서 발생한 대량 피막하 간 혈종의 지연성 파열 1례)

  • Moon, Soo Kyoung;Lee, Tae Suk;Yoon, Hye Sun
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.89-92
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    • 2008
  • A subcapsular liver hematoma (SLH) is a relatively common lesion in fetuses and neonates. Although an SLH ruptures rarely, it may be life threatening. We report on a term neonate with a delayed rupture of an SLH that occurred on day 7 of life. The infant had been resuscitated with intubation, positive pressure ventilation, and chest compression at birth because of meconium-associated perinatal depression. The SLH was diagnosed by abdominal ultrasonography and paracentesis, and the ruptured SLH was treated operatively. After intensive medical and surgical management, the infant was discharged healthy on day 27 of life. A newborn infant presenting with the sudden onset of extreme shock and pallor associated with abdominal distension should undergo differential diagnosis for SLH and a clinical evaluation concurrent with fluid resuscitation and timely surgery.

Bile Peritonitis due to Choledochal Cyst Perforation in Infants (총담관낭 환아에서의 담즙성 복막염)

  • Jung, Jae-Hee;Song, Young-Tack
    • Advances in pediatric surgery
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    • v.4 no.2
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    • pp.156-162
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    • 1998
  • Choledochal cyst is rare in the western countries, but common in oriental countries. Complicatioins include ascending cholangitis, recurrent pancreatities, progressive biliary cirrhosis, portal hypertension, stone formation and later malignant transformation. Bile peritonitis secondary to rupture is one of the rarest complications, with an incidence of 1.8 % to 18 %. The anomalous arrangement of the pancreatobiliary ductal system with a long common channel may cause inflammation leading to perforation of the cyst. The authors found 4 cases (14.2 %) of bile peritonitis among 28 cases of choledochal cyst treated from Jan. 1983 to Jan. 1998. The patients ages ranged from 6 months to 3 years and three were female. The perforation sites were located on the common bile duct at its junction with the cystic duct in 2 cases, the distal cyst wall in 1 case and the left hepatic duct at its junction with cyst in 1 case. The types of choledochal cysts by Todani's classification were Type IVa in 3 cases and type I in 1 case. By the new Komi's classification utilizing operative cholangiogram there were 2 cases of Type Ia, 1 case of type IIb and 1 case of type III. One stage cyst excision and hepaticojejunostomy(Roux-en Y type) was done in 3 cases, and two staged operation in 1 case. All patients had an uneventful course postoperatively. The average day of discharge was 9.8th postoperatively. In conclusion, primary excision of the choledochal cyst and biliary reconstruction is a safe and effective treatment of ruptured choledochal cyst in infants.

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Surgical Treatment of Gastric Gastrointestinal Stromal Tumor

  • Kong, Seong-Ho;Yang, Han-Kwang
    • Journal of Gastric Cancer
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    • v.13 no.1
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    • pp.3-18
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    • 2013
  • Gastrointestinal stromal tumor is the most common mesenchymal tumor in the gastrointestinal tract and is most frequently developed in the stomach in the form of submucosal tumor. The incidence of gastric gastrointestinal stromal tumor is estimated to be as high as 25% of the population when all small and asymptomatic tumors are included. Because gastric gastrointestinal stromal tumor is not completely distinguished from other submucosal tumors, a surgical excisional biopsy is recommended for tumors >2 cm. The surgical principles of gastrointestinal stromal tumor are composed of an R0 resection with a normal mucosa margin, no systemic lymph node dissection, and avoidance of perforation, which results in peritoneal seeding even in cases with otherwise low risk profiles. Laparoscopic surgery has been indicated for gastrointestinal stromal tumors <5 cm, and the indication for laparoscopic surgery is expanded to larger tumors if the above mentioned surgical principles can be maintained. A simple exogastric resection and various transgastric resection techniques are used for gastrointestinal stromal tumors in favorable locations (the fundus, body, greater curvature side). For a lesion at the gastroesophageal junction in the posterior wall of the stomach, enucleation techniques have been tried preserve the organ's function. Those methods have a theoretical risk of seeding a ruptured tumor, but this risk has not been evaluated by well-designed clinical trials. While some clinical trials are still on-going, neoadjuvant imatinib is suggested when marginally unresectable or multiorgan resection is anticipated to reduce the extent of surgery and the chance of incomplete resection, rupture or bleeding.

Sterculic Acid and Its Analogues Are Potent Inhibitors of Toxoplasma gondii

  • Hao, Pan;Alaraj, Intisar Q.M.;Al Dulayymi, Juma'a R.;Baird, Mark S.;Liu, Jing;Liu, Qun
    • Parasites, Hosts and Diseases
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    • v.54 no.2
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    • pp.139-145
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    • 2016
  • Toxoplasmosis is a serious disease caused by Toxoplasma gondii, one of the most widespread parasites in the world. Lipid metabolism is important in the intracellular stage of T. gondii. Stearoyl-CoA desaturase (SCD), a key enzyme for the synthesis of unsaturated fatty acid is predicted to exist in T. gondii. Sterculic acid has been shown to specifically inhibit SCD activity. Here, we examined whether sterculic acid and its methyl ester analogues exhibit anti-T. gondii effects in vitro. T. gondii-infected Vero cells were disintegrated at 36 hr because of the propagation and egress of intracellular tachyzoites. All test compounds inhibited tachyzoite propagation and egress, reducing the number of ruptured Vero cells by the parasites. Sterculic acid and the methyl esters also inhibited replication of intracellular tachyzoites in HFF cells. Among the test compounds, sterculic acid showed the most potent activity against T. gondii, with an $EC_{50}$ value of $36.2{\mu}M$, compared with $EC_{50}$ values of $248-428{\mu}M$ for the methyl esters. Our study demonstrated that sterculic acid and its analogues are effective in inhibition of T. gondii growth in vitro, suggesting that these compounds or analogues targeting SCD could be effective agents for the treatment of toxoplasmosis.