• Title/Summary/Keyword: laceration

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Computed Tomographic Features of Blunt Abdominal Trauma in a Dog (개에서 컴퓨터단층촬영을 이용한 복부 장기 열상 진단 1례)

  • Park, Hyun-young;Seo, Ji-won;Lee, Young-won;Choi, Ho-jung
    • Journal of Veterinary Clinics
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    • v.33 no.1
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    • pp.39-42
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    • 2016
  • A 10 months old, male Poongsan dog was referred with a history of right forelimb lameness due to hit by a car a few hours before presentation. On the physical examination, the dog showed pale mucous membrane, respiration distress, and skin abrasions. The main laboratory finding was leukocytosis, while hematocrit was normal. Abdominal radiography revealed the loss of abdominal serosal detail, which was diagnosed as peritoneal hemorrhage on ultrasonography (US) and aspiration. On computed tomography (CT), hepatic and splenic injuries were seen characterized by the discontinuity of the capsule with irregular margin and lower density lesions than parenchyma. No contrast enhancing area were shown in the laceration lesion. The accessory spleen was incidentally found by US and CT. In this case, acute intra-abdominal hemorrhage from splenic and hepatic laceration was diagnosed using CT.

Extensive Blunt Hepatic Injury due to Cross-over Traffic Accident - A Case Report of Conservative Management (전단교통사고에 의한 광범위 간장손상 - 보존치료 1례)

  • Jang, In-Seok;Kim, Sung Hwan;Lee, Jung Eun;Kim, Jong Woo;Choi, Jun Young;Shin, Il Woo;Kim, Hyun Ok
    • Journal of Trauma and Injury
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    • v.27 no.3
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    • pp.84-88
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    • 2014
  • The severity of blunt hepatic injury correlates with internal organ damage. We experienced a patient, who had an extensive crushed liver injury. The patient was a 28-year-old man, who was involved in a traffic accident in which a wheel ran over his right upper abdomen. A grade V severe hepatic laceration was diagnosed with computed tomography. His vital signs were stable, so we could wait for times with conservative management. Bile leakage led to biloma and bile spillage into the peritoneal space. Selective percutaneous drainage was needed to control the several biloma. After four months of conservative management, could the patient was discharged in good condition.

Periotome versus piezotome as an aid for atraumatic extraction: a randomized controlled trial

  • Mohammed Abdullah, Alraqibah;Jingade Krishnojirao Dayashankara, Rao;Bader Massad, Alharbi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.6
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    • pp.356-362
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    • 2022
  • Objectives: A single-blinded randomized controlled trial was designed to compare and evaluate the effectiveness of the periotome and piezotome as aids for atraumatic extraction and its sequalae. Materials and Methods: The study sample comprised 48 teeth, equally allotted to the piezotome or periotome groups by random allocation, in participants aged 19-62 years. All samples in both groups had either complete tooth structure or intact roots without crowns and had mobility ≤grade II. Clinical parameters of operative duration, presence or absence of gingival laceration, reported operative and postoperative pain, and intake of analgesics following extraction were recorded. IBM SPSS software package version 22 was used for data entry and analysis. Results: The mean operation time was significantly (P≤0.05) longer in the piezotome group than in the periotome group. However, fewer gingival lacerations were observed with use of a piezotome than with a periotome, although no significant difference was observed. The piezotome group reported significantly (P≤0.05) higher visual analog scale (VAS) pain scores during the procedure and non-significantly higher scores thereafter until the third postoperative day. In the piezotome group, the dosage of analgesic was higher, although the periotome group had a higher percentage of participants who used analgesics postoperatively; however, these differences were not statistically significant. Conclusion: The present clinical trial favors the use of periotome over piezotome for atraumatic extraction due to shorter operating time, lower postoperative VAS pain scores, and lower dosage of analgesics despite the superior ability of the piezotome to prevent gingival laceration.

A Survey on Procedural Sedation and Analgesia for Pediatric Facial Laceration Repair in Korea

  • Dongkyu Lee;Hyeonjung Yeo;Yunjae Lee;Hyochun Park;Hannara Park
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.30-36
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    • 2023
  • Background Most children with facial lacerations require sedation for primary sutures. However, sedation guidelines for invasive treatment are lacking. This study evaluated the current status of the sedation methods used for pediatric facial laceration repair in Korea. Methods We surveyed one resident in each included plastic surgery training hospital using face-to-face interviews or e-mail correspondence. The health care center types (secondary or tertiary hospitals), sedation drug types, usage, and dosage, procedure sequence, monitoring methods, drug effects, adverse events, and operator and guardian satisfaction were investigated. Results We included 45/67 hospitals (67%) that used a single drug, ketamine in 31 hospitals and chloral hydrate in 14 hospitals. All health care center used similar sedatives. The most used drug administered was 5 mg/kg intramuscular ketamine (10 hospitals; 32%). The most common chloral hydrate administration approach was oral 50 mg/kg (seven hospitals; 50%). Twenty-two hospitals (71%) using ketamine followed this sequence: administration of sedatives, local anesthesia, primary repair, and imaging work-up. The most common sequence used for chloral hydrate (eight hospitals; 57%) was local anesthesia, administration of sedatives, imaging work-up, and primary repair. All hospitals that used ketamine and seven (50%) of those using chloral hydrate monitored oxygen saturation. Median operator satisfaction differed significantly between ketamine and chloral hydrate (4.0 [interquartile range, 4.0-4.0] vs. 3.0 [interquartile range, 3.0-4.0]; p <0.001). Conclusion The hospitals used various procedural sedation methods for children with facial lacerations. Guidelines that consider the patient's condition and drug characteristics are needed for safe and effective sedation.

The efficacy of optimal doses of intramuscular ketamine and midazolam injections for procedural sedation in laceration repair of children (소아 열상 처치에서 적절한 용량의 ketamine과 midazolam 병용 근육주사의 진정효과)

  • You, Je Sung;Cho, Young Soon;Choi, Young Hwan;Kim, Seung Hwan;Lee, Hahn Shick;Lee, Jin Hee
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.726-731
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    • 2006
  • Purpose : We reported previously that intramuscular ketamine with adjunctive midazolam is more effective than ketamine alone in pediatric procedural sedation, but with limited satisfactory sedation by suboptimal ketamine dose. The optimal dose of intramuscular ketamine in children has never been studied in Korea. In this study, we investigated the effectiveness and adverse events of ketamine 4mg/kg with adjunctive midazolam in pediatric laceration repair. Methods : From Jan. 2005 to July 2005, we enrolled 60 children, aged 3 months-7 years, who needed laceration repair under sedation. After verbal consent from parents, patients were randomly assigned to KMA group(IM ketamine 4 mg/kg+atropine 0.01 mg/kg+intramuscular midazolam 0.05 mg/kg) or KA group(without midazolam). We compared both groups with the induction time, recovery time, total sedation time, efficacy of sedation, adverse effects, and the satisfaction score of treating physicians. Results : Potentially confounding variables, age, weight, injury site and anxiety score, were similar between groups. The induction time, recovery time and total sedation time were not different statistically. In KMA group, 90.9 percent of patients showed satisfactory sedation compared to 66.7 percent of KA group(P=0.02) and the occurrence rate of significant adverse effect was 0.0 percent and 37.0 percent respectively. Conclusion : We found adjunctive midazolam with ketamine doses of 4 mg/kg IM produced more effective, satisfactory sedation and less adverse effect than without midazolam in pediatric laceration repair. The emergence phenomenon(agitation during recovery) only occurred in 9 KA group patients. In spite of adverse effect, all patients recovered, were discharged and there were no reported delayed events.

Emergency In Situ Bypass during Middle Cerebral Artery Aneurysm Surgery : Middle Cerebral Artery-Superficial Temporal Artery Interposition Graft-Middle Cerebral Artery Anastomosis

  • Jung, Jong-Myung;Oh, Chang-Wan;Song, Kyung-Sun;Bang, Jae-Seung
    • Journal of Korean Neurosurgical Society
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    • v.51 no.5
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    • pp.292-295
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    • 2012
  • Many reports have been published on complications related to middle cerebral artery (MCA) aneurysm surgical clipping procedures. We report an emergency intracranial in situ bypass surgery case which was performed as a rescue procedure after aneurysmal neck laceration during clipping of an MCA large aneurysm. In this case, we performed in situ M3-superficial temporal artery (STA) interposition graft-M3 bypass procedure. If a STA-MCA anastomosis is not available under MCA flow obstruction, we can consider an emergency in situ MCA-MCA bypass procedure with or without an STA interposition graft.

Evaluation of Clinical Signs on Equine Coital Exanthema in Thoroughbred Horses (Thoroughbred 말에 발생한 구진의 임상증상 평가)

  • Yang, Jae-Hyuk;Lee, Kyoung-Kap;Lim, Yoon-Kyu
    • Journal of Veterinary Clinics
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    • v.28 no.4
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    • pp.369-374
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    • 2011
  • Coital exanthema of Thoroughbred horses had occurred firstly in Republic of Korea. This study was performed to evaluate clinical features of coital exanthema, and provide veterinary knowledge to equine practitioner as well as horse farms. The method was clinical, clinical pathology and sexual hormone, electron microscope and libido examination. Five stallions of 27, 45 broodmares of 416 showed clinical symptoms but 124 foals and a teaser did not show any abnormal appearance. Five stallion had papule, pustule, crust around a glans, body of penis, prepuce and remain decolorized spot after treatment. One laceration of glans and 3 gait disorder had been observed but it did not affect libido. Forty-five broodmares localized had papule, pustule, crust, and ulceration around perineal region, vulva, mucocutaneous junction remain decolorized spot after treatment.

clinical analysis of vascular trauma (혈관손상의 임상적 고찰)

  • 성숙환
    • Journal of Chest Surgery
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    • v.19 no.2
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    • pp.288-294
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    • 1986
  • During the period from Mar. 1983 to Feb. 1986, 22 patients with vascular trauma were treated at Capital Armed General Hospital. 1] 11 patients had arterial injury alone, 6 patients had venous injury alone, and 5 patients had both arterial and venous injuries. 2] The mechanism of injury in these 22 patients was 7 penetrating non-gun shot wounds, 5 blast fragments injuries, 4 iatrogenic injuries, 4 blunt injuries, 2 gun shot wounds. 3] The method of 16 arterial repair was 5 autogenous saphenous vein graft, 8 synthetic vascular graft, 1 end to end anastomosis, 2 lateral suture. Midterm patency of 16 repairs was 100% within 1 months. 4] The method of 11 venous repair was 1 autogenous saphenous vein graft, 2 onlay vein patch, 2 ligation, 1 lateral suture. The thrombotic obstructions occurred in 4 repairs [36.4%], but they were resolved somewhat with heparinization. 5] Uncommon cases of false aneurysm of internal carotid artery and laceration of retrohepatic inferior vena cava were summarized.

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Surgical Management of Patent Ductus Arteriosus (동맥관개존증의 외과적 요법)

  • 홍종완
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.990-995
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    • 1988
  • Seventeen cases of vascular injuries treated in Chungnam National University Hospital during the period from Apr. 1980 to Sep. 1988 were reviewed. Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries. Of the 11 arterial injuries, 3 were femoral artery which was the commonest in frequency, the next was 2 cases of subclavian, common carotid, iliac artery. Of the 10 venous injuries, the subclavian vein and internal jugular vein were common in frequency. The most frequent type of injuries was laceration[13 cases in 21]. Vascular reconstruction was done by lateral suture repair in 8 cases, autogenous vein graft in 2, prosthetic vascular graft in 5, direct anastomosis in 1 case. Simple ligation was done in 5 cases. There was 1 case of visual field defect as a sequelae in right common carotid artery transaction and 1 case of mortality.

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Penetrating Wounds of the Heart: A Report of Four Cases (심장손상 4례에 대한 치험)

  • 이성구
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.189-194
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    • 1973
  • A cardiac injury is one of the most dramatic and demanding emergencies than may be cared by the surgeon. Four patients who sustained penetrating wound of the heart have been experienced in the Depart-ment of Thoracic Surgery, Kyungpook National University Hospital. They were 3 males and one female. The age was between 21 and 25. All of this series had stab wounds on the heart by instruments of scissors, gimlet, kitchen knife and glass. Injured sites were two cases of right ventricle, one of the right atrium and one of indifinitive with pericardial laceration. Three of these patients have been successfully treated by emergency thoracotomy with 3-0 silk sutures for myocardial penetrating wounds. One of these patients occurred cardiac arrest during surgery and expired, who was in penetrated right ventricular injury through which massive bleeded. The classic clinical description of tamponade, Beck`s triad, seemed to be useful for making diagnosis of the tamponade but not entirely reliable as diagnostic criterion of the tamponade. In the studing of 3 tamponade cases in these series, the triad of Beck was presented in only two cases. Elevated venous pressure was thought to be a valuable diagnostic factor in pericardial tamponade.

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