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Clinical Review of Diaphragmatic Hernia (횡경막 탈장의 임상적 고찰)

  • 장기경
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.837-841
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    • 1995
  • Between June 1981 and April 1994, 15 patients underwent surgical repair of diaphragmatic hernia. The ages ranged from 1 day to 60 years, with a mean age of 34. There were 5 cases of congenital diaphragmatic hernia; Bochdalek hernia in 4 cases and Morgagni hernia in 1 case. There were 10 cases of traumatic diaphragmatic hernia;blunt trauma in 8 cases and stab wounds in 2 cases. The chest X-ray findings were abnormal in 10 cases. Operations were performed in all patients and there was only one death, who was a newborn with left Bochdalek hernia and pulmonary hypoplasia.

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Combined Cervical Tracheoesophageal Injury by Penetrating Trauma - 2 Cases Reports - (경부 자상에 의한 기관 및 식도의 동시 절단 치험 2례)

  • 김택진
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.382-385
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    • 1990
  • In recent era, the incidence of combined injury of cervical trachea and esophagus by penetrating wound has been increased considerably. If initial operative repair is unsatisfied, devastating complications and even death may be considered. A 5 years old boy and 67 years old female were admitted to our department for deep cervical stab wounds. On exploration, cervical trachea and esophagus was nearly total transected anteroposteriorly. Emergent reconstructive surgery for trachea and esophagus had done. Postoperative course was uneventful without any complications.

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Arteriovenous Fistula between Renal Artery and Inferior Vena Cava following Penetrating Abdominal Trauma; A Case Report (자상 후 발생한 신동맥과 하대정맥간 정맥루)

  • Kim, Joong Suck;Go, Seung Je;Kim, Ji Dae;Sul, Young Hoon;Ye, Jin Bong;Park, Sang Soon;Ku, Gwan Woo;Kim, Yeong Cheol
    • Journal of Trauma and Injury
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    • v.28 no.4
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    • pp.262-265
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    • 2015
  • An arteriovenous fistula (AVF) from the renal artery following a penetrating abdominal trauma is not common. We report the case of a 19-year-old male who presented with a knife stab wound in the right upper quadrant. Due to unstable vital signs and to the protrusion of the mesentery through the stab wound, providing definite evidence of peritoneal violation, an emergent exploratory laparotomy was carried out. There were injuries at the proximal transverse mesocolon and the second portion of the duodenum, with bile leakage. There was also a mild amount of retroperitoneal hematoma near the right kidney, without signs of expansion or pulsation. The mesocolon and the duodenum were repaired. After the operation, abdominal computerized tomography (CT) was performed, which revealed contrast from the right renal artery shunting directly into the vena cava. Transcatheter arterial embolization with a coil and vascular plug was performed, and the fistula was repaired. The patient recovered completely and was discharged without complication. For further and thorough evaluation of an abdominal trauma, especially one involving the retroperitoneum, a CT scan is recommended, when possible, either prior to surgery or after surgery when the patient is stabile. Furthermore, a lateral retroperitoneal hematoma and an AVF after a penetrating trauma may not always require exploration. Sometimes, it may be safely treated non-operatively or with embolization.

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Modified Double-Eyelid Blepharoplasty Using the Single-Knot Continuous Buried Non-Incisional Technique

  • Moon, Kyung-Chul;Yoon, Eul-Sik;Lee, Jun-Mun
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.409-413
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    • 2013
  • Background Buried non-incisional double-eyelid blepharoplasty is a popular aesthetic procedure. Although various modified continuous suture techniques have been used to create a more natural appearance and to reduce downtime, complications such as loosening of the double fold, asymmetry, and foreign body reactions have been observed. Methods This study included 250 patients who underwent double-eyelid blepharoplasty between March 1997 and November 2012 using a modified single-knot continuous buried non-incisional technique. With 4 stab incisions in the upper eyelids, one of two needles loaded with double-armed 7-0 nylon was passed in one direction alternately through the dermis and the conjunctiva, while the other needle was passed subconjunctivally in the opposite direction. Both ends of the sutures were knotted within a lateral stab incision of the upper eyelids and were buried in the orbicularis oculi muscle. Results Most patients displayed satisfactory aesthetic results, and no significant complications occurred. There was no obvious regression of the double fold; however, 3 patients required reoperation to correct loosening of the fold on one side during the follow-up period. One patient presented with the suture knot subcutaneously, and the knot was removed in the clinic. Conclusions The modified single-knot continuous buried non-incisional technique is a simple and less time-consuming method for a durable double fold and provides satisfactory aesthetic results.

Eleven Cases on Peripheral Arterial Injuries (말초동맥손상 11례 보고)

  • 이승진;이남수;김형묵
    • Journal of Chest Surgery
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    • v.7 no.1
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    • pp.109-116
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    • 1974
  • Eleven cases of peripheral arterial injuries treated at Korea University Woo Sok Hospital during these 3 years and 3 months from Feb. 1971Eleven cases of peripheral arterial injuries treated at Korea University Woo Sok Hospital during these 3 years and 3 months from Feb. 1971 to May 1974 were reviewed. Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries during operation. Of the 11 arterial injuries 3 were femoral artery which` was the commonest in frequency and the next was 2 cases of brachial artery. The most frequent type of injury was transection. Laceration, contusion and spasm was also recognized. The need to operate immediately following an injury was emphasized. Operative procedures were end to end anastomosis and saphenous vein graft in 5 and 2 cases, respectively. Other cases were undergone multiple suture ligature due to staphyllococcal infection, insertion of polyethylene catheter, and lateral suture after thromboendarterectomy. Fractures and extensive soft tissue damage associated with arterial injuries with widespread destruction of the collateral circulation aggravated the situation and complicated the amputation of lower extremity in 4 cases. The factors influencing the amputation were time lag, presence of associated injuries and complications.[KTCS 1974;1:109-116] Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries during operation. Of the 11 arterial injuries 3 were femoral artery which` was the commonest in frequency and the next was 2 cases of brachial artery. The most frequent type of injury was transection. Laceration, contusion and spasm was also recognized. The need to operate immediately following an injury was emphasized. Operative procedures were end to end anastomosis and saphenous vein graft in 5 and 2 cases, respectively. Other cases were undergone multiple suture ligature due to staphyllococcal infection, insertion of polyethylene catheter, and lateral suture after thromboendarterectomy. Fractures and extensive soft tissue damage associated with arterial injuries with widespread destruction of the collateral circulation aggravated the situation and complicated the amputation of lower extremity in 4 cases. The factors influencing the amputation were time lag, presence of associated injuries and complications.

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Replantation of Nose Amputation by Use of Medical Leech (거머리를 이용한 코 절단의 재접합술)

  • Yim, Youngmin;Kwan, Ho;Oh, Deuk Young;Lee, Ji Yeon;Jung, Sung-No
    • Archives of Plastic Surgery
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    • v.32 no.1
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    • pp.124-130
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    • 2005
  • In the microsurgical era, replantation with microvascular anastomosis is considered as the most superior method in aspects of texture, color, shape in case of nose amputation. There are some reported cases of replantation in nose amputation historically, but most of them are composite graft cases rather than microvascular anastomosis. Only a few cases of successful nasal replantation with microvascular anastomosis have been reported due to the reason that the size of vessels is usually very small and identifying suitable vessels for anastomosis is difficult. Microanastomosis of artery and microanastomosis of vein are ideal in replantation, but identifying suitable veins is often difficult. Without venous anastomosis, resolving the venous congestion remains to be a problem. We can carry out arteriovenous shunt if we can find two arteries in amputee. However, the smaller the size of amputee is, the more difficult it is to find two arteries. Instead of arteriovenous shunt, we can try external venous drainage(frequently swab, pin-prick, stab incision, IV or local heparin injection, dropping, apply of heparin-soaked gauze, use of medical leech). Here, we present three cases of replantation with microscopical arterial anastomosis (one angular artery, two dorsal nasal arteries) and external venous drainage (stab incision, application of medical leech and heparin-soaked gauze) even though the size of amputee may be as small as $1.5{\times}1.0cm$. In all cases, surgical outcomes were excellent in cosmetic and functional aspects. This report describes successful replantation by microvasular anastomosis in case that suitable veins are not found.

The new classification for fatty-type gynecomastia (lipomastia) and 1000 cases review (지방형 여성형유방증에 대한 새로운 분류와 1000증례)

  • Yoon, Sang Yub;Kang, Min Gu
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.773-778
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    • 2009
  • Purpose: The authors propose the new classification of fatty - type gynecomastia(lipomastia) which can serve as a guide for modifying the periareolar technique. Methods: A retrospective analysis was made of 1000 cases of lipomastia operated on in the last 17 months. The extent of the clinical result, the technique employed, and the complications were observed. On the basis of this review the authors observed that at grade I(fat component < 50 ml, fibroglandular component < 3 g each breast), flattening of the thorax can be achieved by means of stab incision, ultrasound - assisted lipectomy(UAL), scavenging suction - assisted lipectomy(SAL) and tissue shaving. At grade II(50 < < 150 ml, 3 < < 5 g), stab incision, UAL, SAL and pull - out method(POM) using small curved scissors. At grade III(150 < < 300 ml, 5 < < 15 g and prominent inframammary fold(IMF)), minimal incision (5 - 6 mm), UAL, SAL and POM using small angulated scissors, and blunting IMF. At grade IV (300 < < 500 ml, 15 < < 30 g, and glandular ptosis), minimal incision (5 - 6 mm), UAL, SAL, fibroglandular excision using small angulated scissors, cutting IMF and fixation of nipple - areola complex(NAC) becomes necessary. At grade V (> 500 ml, > 30 g and ptosis), small incision (7 - 8 mm), UAL, SAL, fibroglandular excision using large angulated scissors, cutting IMF, upper repositioning of NAC and delayed circumareolar skin reduction or chest lifting becomes necessary. Results: The complications were minimal but there were hematoma (n = 7), infection (n = 3) and hypertrophic scar (n =13). Almost patients were satisfied with the outcome. Conclusion: This simple classification may help in choosing the most suitable treatment, thus avoiding insufficient or invasive treatments and undesirable scars.

The First Written Medical Record on Thoracic Surgery in Korean History (한국사 최초의 흉부외과 관련 의학기록)

  • Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.813-820
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    • 2009
  • On Dec 22, 1909, a young patriot called Lee Jae-Myung (1986~1910) attempted to assassinate Lee Wan-Yong, the prime minister of the last Yi Choseon cabinet and he later signed the annexation treaty with imperial Japan. Despite that Lee Jae-Myung failed in this assassination attempt, his heroic deed motivated national pride thereafter. After this attempted assassination, a medical record was prepared about stab wound that was inflicted upon Lee Wan-Yong during the trial of Lee Jae-Myung, and this record included many significant specific descriptions that were concerned with thoracic surgery. They included an intercostal stab wound and intercostal arterial hemorrhage, lung injury, chest contusion, traumatic pleuritis and supposedly pneumo-and hemothorax. Thoracentesis for drainage of the serosanguinous pleural effusion was also mentioned. This medical record is judged to be the first written medical record on thoracic surgery in Korean history. The aim of this study is to analyze the content of the record as it is related with a well known episode in modern Korean history.

Penetrating Neck Trauma: A Case of Spinal Cord Injury by Embedded Scissor (척수 손상을 일으킨 경부 가위 관통상)

  • Kim, Seon Hee;Choi, Sun Woo;Park, Sung Jin;Yeo, Kwang Hee;Kim, Chang-Wan;Lee, Sang Bong;Kim, Ho Hyun;Park, Chan-Yong;Kim, Jae Hun;Hwang, Jung Joo;Cho, Hyun Min
    • Journal of Trauma and Injury
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    • v.28 no.2
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    • pp.71-74
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    • 2015
  • Penetrating neck trauma involving spinal cord injury is relatively uncommon, but can be life-threatening. We report a case of 59-year-old female who presented with hypotension after stab injury self-inflicted with a scissor to her neck. Although Open removal of the scissor and control of bleeding were successfully done, penetration of spinal cord resulted in a neurologic impairment.

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Analysis of Wire-Mesh Half Slab by Layer Model (Layer모델에 의한 와이어 메쉬 하프슬래브의 해석)

  • Yi, Waon-Ho;Lee, Li-Hyung;Chung, Lan;Park, Chil-Lim
    • Proceedings of the Computational Structural Engineering Institute Conference
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    • 1994.04a
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    • pp.73-80
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    • 1994
  • This paper is to study the mechanical behavor and structural safety of the wire-mesh half slab by an analytical method. Layer model was adopted by modelling the wire-mesh half slab as a flexural member composed of free cantilever beam and vertical supports (walls or beams). Reasonable results for the prediction of ultimate strength of the half stab at each loading direction and design recommendations for the reinforcement detail at wall(beam)-slab joints are acquired. On the other hand, ductility capacity of the wire-mesh half slab was overestimated by not considering the brittleness of wire-mesh reinforcements pre-manufactured at the form of Kaiser Truss.

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