• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1348-1363
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• 2020

The newly revised 2018 Organ Injury Scale (OIS) has a similar format to the previous American Association for Surgery and Trauma (AAST) Emergency General Surgery Grading System, dividing the criteria for grading solid organ damage into three groups; imaging, operation, and pathology. The most significant alteration in the OIS system 2018 revision is the incorporation of multidetector CT (MDCT) findings of vascular injury including pseudoaneurysm and arteriovenous fistula. Similar to the previous OIS, the highest of the three criteria is assigned the final grade. In addition, if multiple grade I or II injuries are present, one grade is advanced for multiple injuries up to grade III. This pictorial essay demonstrates the MDCT findings of solid organ injury grades based on the 2018 OIS system.

• Archives of Plastic Surgery
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• v.34 no.5
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• pp.599-604
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• 2007

Purpose: Blowout fractures of the orbit are common sequelae to blunt facial trauma and now increasing in number due to automobile accidents, violence and industrial disasters. There are some reports of diagnosis and treatment of this fracture, but detailed data provided in overall aspects are very few. We analysed extensive data to provide guide line of blowout fracture patients care. Methods: We retrospectively studied 387 orbital blowout fracture patients who had been followed up at least 3-6 months. Their hospital records were reviewed according to causes, fracture site, operation methods, and follow up results, etc. Results: The ratio of males to females was 7 : 3 and fractures were most often seen in the 20-29 age group. 180(47%) patients had medial orbital wall fractures, 155(40%) patients had floor fractures and 52(13%) patients had a combination of orbital floor and medial wall fractures. The highest associated bone fracture was the nasal bone(37%). The open reduction was done in the 324 patients(83.7%) and insertion materials were used in the 249 patients(77%). Total 45 patients(14%) complained of residual diplopia and 26 patients(8%) kept mild enophthalmos. 24 patients(7%) showed some restriction of extraocular muscle movements. Conclusion: We broadly surveyed the information of blow out fracture patients and believe that this study provides important prognostic information that can be of benefit to both patient and surgeon during preoperative counseling and postoperative analysis of orbital blowout fractures.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.327-336
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• 1977

A chinical analysis was performed on 383 ases of hest injurjes eperienced at Department of thoraci Surgery, Seoul National University Hospital during 21 year period From 1957 to 1977. Of 383 patients o hest injuries, 209 cases were result from nonpenetrating injuries whereas 175 were from penetrating injuries, and there were 258 cases of hemothorax or/and pneumothorax, 162 of rib fracture, 33 of foreign body, 26 of clavicle frcture, 26 of lung contusion, 17 of diaphragmati laceration, 14 of hemoperiardium, 14 of flail chest and others. Stab wound was the most common in penetrating injuries and followed by gunshot and shell fragments. The majority of nonpenetrating chest injury paiens were traffi accident vitims and falls accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 16 and 50 years, and 321 patients were male comparing to 62 of female. In blunt hest injuries the patients with five or more rib fractures had a 85 per ent incidence of intrathoracic injury and 19 per cent had an intraabdominal organ damage, whereas those with four or less rib fractures had a 69 per cent and a 6 per cent incidence respectively. The principal associated injuries were cerebral contusion on 19 cases, renal contusion on 10, liver laceration on 7, peripheral vessel laceration on 5, spleen laceration on 3 and extremity fracture on 18 patients. The principles of therapy for early complications of chest trauma were rapid reexpansion of the lungs by thoracentesis (46 cases) and closed thoracotomy (125 cases) but open thoracotomy had to be done on 90 cases (23.5%) because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic laceration and bronhial rupture. The over all mortality was 2.87 per cent (11 among 383 cases), 8 cases were from penetrating injuries and 3 from nonpenetrating injuries.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.337-342
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• 1977

A clinical analysis was performed on 383 cases of chest injurjes experienced at Department of Thoracic Surgery, Seoul National University Hospital during 21 year period from 1957 to 1977. Of 383 patients of chest injuries, 209 cases were result from nonpenetrating injuries whereas 175 were from penetrating injuries, and there were 258 cases of hemothorax or/and pneumothorax, 162 of rib fracture, 33 of foreign body, 26 of clavicle fracture, 26 of lung contusion, 17 of diaphragmatic laceration, 14 of hemopericardium, 14 of flail chest and others. Stab wound was the most common in penetrating injuries and followed by gunshot and shell fragments. The majority of nonpenetrating chest injury patients were traffic accident victims. and fails accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 16 and 50 years, and 321 patients were male comparing to 62 of female. In blunt chest injuries the patients with five or more rib fractures had a 85 per cent incidence-of intrathoracic injury and 19 per cent had an intraabdominal organ damage, whereas those with four or less rib fractures had a 69 per cent and a 6 per cent incidence respectively. The principal associated injuries were cerebral contusion on 19 cases, renal contusion on 10, liver laceration on 7, peripheral vessel laceration on 5, spleen laceration on 3 and extremity fracture on 18 patients. The principles of therapy for early complications of chest trauma were rapid reexpansion of the lungs by thoracentesis [46 cases] and closed thoracotomy [125 cases] but open thoracotomy .had to be done on 90 cases [23-5%] because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic laceration and bronchial rupture. The over all mortality was 2.87 per cent [11 among 383 cases], 8 cases were from penetrating injuries and 3 from nonpenetrating injuries.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.698-704
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• 1989

We experienced the seven cases of penetrating and non-penetrating cardiac injuries combined with cardiac tamponade from June 1986 to June 1989 at Seoul and Chun-An Hospital of SOONCHUNHYANG medical college. The results were as follows. l. In sex distribution, 7 cases were male. In age distribution, The fourth decades occupied about 58 % of all cases. 2. In mode of injury, 4 cases were stab wounds, 1 case penetration by metallic fragment, 2 cases blunt chest trauma. 3. We routinely checked the CVP with subclavian vein catheterization in case of suspicious cardiac tamponade. Significant increments were showed in 4 cases. 4. Becks triad [low blood pressure, raised central venous pressure, distant heart sound] were recorded in 43 % of the cases with proven tamponades. 5. The sites of injury included RV in 4 cases, LV in 1 case, RA in 1 case and branch of RCA in 1 case. The RV injuries were the most common. 6. Coronary artery damage occurred in 2 cases. LADA was severed in 1 case combined with RV rupture and branch of RCA was torn 1 case. 7. Pericardiocentesis was performed 1 case at another hospital before referring to our hospital. We have never used the procedure because we think that it is potentially dangerous with no clear benefit. 8. Subxyphoid pericardial window was performed in 2 cases of severe cardiac tamponade. We have employed this method to stabilize the patients who had systolic hypotension. 9. Surgical approaches were performed with median sternotomy in 3 cases, thoracotomy in 4 cases. 10. We undertook the simple closure in 6 penetrating cardiac wounds. The removal of impacted metallic fragment was performed under the cardiopulmonary bypass. Simple ligation was performed in 2 cases of coronary artery severance 11. One patient with no sign of life was urgently intubated and undertaken an emergency room thoracotomy on the stretch car without antiseptic preparation. The cardiorrhaphy in 6 cases were performed in the operating theater 12. One patient undertaken emergency room thoracotomy did not survive due to refractory hypovolemic shock. But the remaining 6 patients recovered.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.245-250
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• 1976

A 33 year-old man was admitted with chief complaints of severe sharp pain on left upper interscapular region and motor weakness of left arm for 9 days. He had a history of blunt trauma over left shoulder about 3 years ago. Physical examination showed a ping pong ball sized mass which was located at the left supraclavicular area and was firm, fixed, and nonpulsatile. No bruit or murmur was obtained over the mass. Ipsilaterally, radial, ulnar, and brachial pulse were very weak and ptosis and anhidrosis were noticed. Neurologic examination revealed moderate or severe weakness of flexion and extension of left elbow, wrist and fingers, and anesthesia of the skin in left C8-T1 dermatome and hypalgesia in left C6-C7 dermatome. Retrograde aortography demonstrated complete obstruction of left subclavian artery. An exploratory operation was performed through the left 4th intercostal space. It was found that the mass was a left subclavian aneurysm of traumatic false type. Proximal and distal ligation of the aneurysm were applied and the sac was partially removed. The continuity of the subclavain artery was established by the use of a 6mm. Dacron graft from the root of the subclavian to the axillary artery. Postoperatively the patient was improved from the circulatory and neurologic disturbances.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.1
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• pp.56-59
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• 2009

Closed rupture of the extensor hallucis longus (EHL) tendon is uncommon and rarely reported. We present a Taekwondo player who had sustained a closed rupture of the EHL tendon after striking the other player's shin. He had practiced Taekwondo more than 6 hours a day for more than 6 years, including repetitive striking on the dorsum of the foot, which probably caused degeneration of the EHL tendon. The tendon ends could not be approximated directly, so reconstruction was performed with bisecting the distal tendon and combining the repair of the one end with an intercalary scar tissue and the other with tenodesis to the extensor hallucis brevis. He returned to the preoperative level of activity 6 months postoperatively with a satisfactory range of motion.

• The Korean Journal of Nuclear Medicine
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• v.27 no.2
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• pp.309-314
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• 1993

We report a case of 33-year-old man with a transient splenic uptake who had traumatic multiple rib fractures and hernoperitoneum combined with underlying liver cirrhosis, liver cirrhosis with liver bed laceration and splenomegaly without any other demonstrable splenic lesion due to traffic accident was found by abdominal ultrasound and surgery. Incidentally, $^{99m}Tc$-MDP Bone scan showed whole prominent splenic uptake, spleen was also visible on $^{99m}Tc$ Tin colloid liver scan. We suggest the splenic uptake of the radionuclide temporary splenic infarct to the transient total splenic infarction or unknown traumatic effect.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.1
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• pp.75-79
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• 2008

Blunt trauma, drugs, infection, congenital anomalies of the pancreaticobiliary system, and multisystem diseases are the main causes of acute pancreatitis in children. Various viruses can cause acute pancreatitis, but varicella-induced pancreatitis is unusual and generally observed in adults or immunocompromised patients. We report a rare case of acute pancreatitis associated with varicella-zoster virus infection in a 6-year-old immunocompetent girl. The patient initially presented complaining of severe abdominal pain and repetitive vomiting. The patient had multiple cutaneous crusts that has been caused by preceding varicella infection and had elevated values of serum amylase and lipase. Abdominal ultrasonography demonstrated swelling of the pancreas and pancreatic duct dilatation, findings which were compatible with acute pancreatitis. The patient's clinical and laboratory abnormalities were completely normalized through conservative treatment consisting of fasting, total parenteral nutrition, and analgesic therapy.

• Journal of Chest Surgery
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• v.7 no.2
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• pp.163-168
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• 1974

Five cases of traumatic diaphragmatic hernia were repaired in the Department of Thoracic Surgery, Seoul National University Hospital, during the period from 1967 to 1974. The first case, a 14-year aid girl, was diagnosed as diaphragmatic hernia during laparotomy because of jejunal perforation 3 days after traffic accident. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture on left posterolateral portion was repaired with two layers of nonabsorbable sutures by transthoracic approach. The second case, a 26-year old man,was diagnosed immediately after traffic accident at a local clinic and transferred to this hospital 24 hours later. Herniated stomach, transverse colon and jejunum were repositioned amd diaphragmatic rupture,about 9 cm in length,from the posterolat.edge to the base of pericardium was sutured in two layers. The third case, a 26-year old man who had stab wound on the left lower lateral chest two years ago,was admitted with sudden abdominal pain and vomiting. Upper gastrointestinal series with barium meal revealed diaphragmatic hernia. The herniated stomach and transverse colon through the defect,about 3.5cm in diameter, at anterolateral portion on the left side,were repositioned and repaired with two layers of nonabsorbable sutures. The forth case, a 26-year old man, sustained blunt trauma to the chest by a roller and was transferred to the emergency room complaining of dyspnea 40 minutes after the accident. The diaphragmatic rupture extended from left midaxillary line to contralateral anterior axillary line,about 20cm long, at anterior portion of diaphragm, which was repaired with two layers, of nonabsorbable sutures. The fifth case, a 4-year old girl, had two separate diaphragmatic ruptures on both sides, which were caused by traffic accident. Immediate upper gastrointestinal series after injury showed herniated stomach, colon and spleen into left Chest cavity. Another small rupture with anterior edge of right lobe of the liver in chest cavity was noted. These were repaired with non-absorbable sutures via thoracotomy.