• Journal of Trauma and Injury
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• v.18 no.1
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• pp.17-25
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• 2005

Background: Traumatic rupture of the aorta is a life-threatening injury that must be diagnosed as rapidly as possible and treated immediately. The chest X-ray is a valuable tool for screening traumatic rupture of the aorta in blunt chest trauma. And various chest radiologic parameters are being used as diagnostic tools for aortic injury. The purpose of this study is to identify chest radiographic parameters that may assist in the detection of traumatic rupture of the aorta and to compare these findings with those of other reports. Methods: This study involved 30 adult patients with traumatic rupture of the aorta seen at the emergency department of the Asan Medical Center from 1997 to 2004. The control subjects were 30 healthy patients with neither lung nor cardiovascular disease. We retrospectively assessed over 14 parameters on chest X-rays. Results: In 11 of the 14 parameters, there were significant differences between the study group and the control group. There was no significant difference in the M/C ratio (mediastinumto-chest width ratio) between the two groups, and neither the left nor the right paraspinal interface was statistically significant (p value>0.05). Our study indicates that new criteria for the MC ratio and for the paraspinal interfaces are needed for screening traumatic aorta injury. The other radiographic parameters for traumatic rupture of the aorta need to be further assessed through a prospective study.

• Journal of Chest Surgery
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• v.35 no.10
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• pp.740-744
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• 2002

Retrograde cerebral perfusion under hypothermic circulatory arrest is a simple and useful adjunct to avoid cerebral ischemic injury in the treatment of aortic arch pathology. In the surgery of distal aortic arch and proximal descending aortic lesions through the left thoracotomy incision, right atrium-retrograde cerebral perfusion (RA-RCP) through a venous cannula positioned into the right atrium is simpler than retrograde cerebral perfusion through superior vena cava. The time limits for RA-RCP during aortic arch reconstruction have yet to be clarified. We, herein, present a case with uneventful recovery after RA-RCP of 94 minutes during reconstruction of aortic arch and descending aorta. These data suggest that RA-RCP, as an adjunct to hypothermic circulatory arrest, may prolong the circulatory arrest time and thus prevent ischemic injury of the brain, even when RA-RCP exceeds 90 minutes.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.279-281
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• 2009

A 38-year old man was admitted to our hospital due to a $5{\times}6cm$ sized pulsating mass in the right neck. He suffered from intermittent neck pain and hoarseness for two months due to the rapidly growing mass. The radiological examinations revealed an aneurysm of the right common carotid artery near the bifurcation, and it was compressing the internal and external carotid arteries. Endarterectomy of the right internal carotid artery, aneurysmectomy of the right common carotid artery and graft interposition were done, while the cerebral circulation was maintained by an internal shunt. Intraoperative injury to the nerve tissue around the aneurysm was avoided. He was discharged on the postoperative 7th day without any complications.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.667-670
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• 2008

Occult bronchial foreign bodies are rare in adults, whereas tracheobronchial aspiration of foreign bodies occurs commonly in children. Treatment guidelines, according to the severity of the bronchial or lung parenchymal damage and the duration of foreign body retention, have not been established. A 40-year-old man with chronic cough, sputum production, and fever was transferred for treatment of right middle and lower lobe collapse and obstructive pneumonitis as evidenced by imaging studies. He had aspirated the cap of a felt-tipped pen 30 years before presentation, which was unrevealed until his medical history was carefully reviewed during this episode. The patient was treated with right middle-lower bilobectomy because fiberoptic bronchoscopic removal of the foreign body failed. This case added important information to our body of knowledge concerning the various clinical features of occult bronchial foreign bodies.

• Journal of Biomedical Engineering Research
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• v.24 no.1
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• pp.15-21
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• 2003

In this study, for a safetv assessment of light weight wheelchair occupant in frontal crash, we tested a dynamic sled impact test. we carried out total 6 times test and impact speed was 20g/48 km/h. By using Hybrid III 50%ile male dummy, head injury criteria(HIC), neck flexion moment, neck axial tension force, neck shear force. chest acceleration, head, wheelchair and knee excursion were measured, we evaluated light weight wheelchair occupant safety by motion criteria(MC) which proposed in SAE J2249 and combined injury criteria(CIC) which is a voluntary standard(GM-IARV) of General Motors Co.. when we assumed that the maximum injury value in frontal crash was 100%, the result of motion criteria(MC) of wheelchair occupant was 52%, occupant upper body injury index(CIC) was 60.1%.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.929-935
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• 1990

Violence in our society, combined with improving transport system, resulted in increased numbers of patients with cardiac wounds reaching the hospital alive. Most patients with penetrating cardiac injury, rather than blunt injury, present with a syndrome of either hemorrhagic shock or cardiac tamponade. And they should be operated upon as soon as possible. Often the atrioventricular valves and other important cardiac structures are also damaged by the penetrating instruments or missile. Both intracardiac communications and atrioventricular fistulas may result in significant left-to-right shunts accompanied by congestive heart failure, necessitating surgical correction. Usually, retained cardiac foreign bodies, which are almost always bullets or fragments of missiles, may lie within a cardiac chamber or in the myocardium. Emboli of bullets or other missiles from distant sites to the right side of the heart are numerous enough to require attention. Recently we experienced a case with intracardiac foreign body due to penetrating cardiac injury. A 19 year-old man was admitted to our hospital due to penetrating anterior chest wound by iron segment. The roentgenogram of the chest revealed a radio-opaque metallic shadow in left lower chest around the cardiac apex, mild blunting of left costophrenic space, but no cardiomegaly. During operation the foreign body was noted to be present in the cardiac chamber by the portable C-arm fluoroscopy. But during the manipulation it moved into left inferior pulmonary vein from left ventricle by way of left atrium. So we could manage to remove it from left inferior pulmonary vein by direct approach to the vein. It was iron segment, sized 0.lcm x0.6cmx0.5cm, with sharp margins. The patient had an uneventful postoperative recovery except for chylopericardium and was discharged.

• Journal of Trauma and Injury
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• v.19 no.1
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• pp.35-40
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• 2006

Purpose: Injuries are the third leading cause of death in Korea. Isolated chest injury is not uncommon and shows high mortality and morbidity. Several scoring systems are used for triage and stratification for trauma patients, but no standard system is accepted. We aimed to analyze the accuracy of identification of isolated chest injury by using several scoring systems. Methods: We reviewed a total of 75 patients admitted with isolated chest injury between January 2005 and October 2005. Medical records were reviewed by using the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma and Injury Severity Score (TRISS). The scoring systems were compared by using statistics methods. Results: The overall predictive accuracy of the TRISS was 12.5%, 12.0% greater than those of the RTS and the ISS. By using the area under the receiver operating characteristic (AUROC) curve, the TRISS showed an excellent discriminative power (AUROC 0.931) compared to the ISS (AUROC 0.926) and the RTS (AUROC 0.872). Conclusion: Compared with the RTS and the ISS, the TRISS is an easily applied tool with excellent prognostic abilities for isolated chest trauma patients. However, the TRISS, the ISS, and the RTS showed high specificity and low sensitivity, so another scoring system is required for triage and stratification of isolated chest injury patients.

• 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.

• Journal of Chest Surgery
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• v.35 no.11
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• pp.831-834
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• 2002

When any part of the pacemaker system is infected, all pacemaker hardware should be removed, because reinfection rates of 51% to 77% have been noted in patients whose infected pacemaker system has been only partially explanted. The removal of infected leads during cardiopulmonary bypass prevents mechanical injury as well as the spread of infection and vegetation. We report one case of endocarditis by staphylococcus aureus with infected transvenous pacing lead which was migrated into the heart from the left subclavian vein. We removed the migrated pacing lead and vegetation under cardiopulmonary bypass.

• Journal of Chest Surgery
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• v.33 no.7
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• pp.541-546
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• 2000

Background; Pericardial adhesion poses a major problem during re-operative cardiac surgery. The purpose of this study was to determine the effect of sodium carboxymethol cellulose on experimental pericardial adhesions. Material and Method; Twenty-four rabbits were divided into 2 groups of 12 rabbits each and pericardial mesothelial injury was induced by abrasion. Group A included rabbits receiving intrapericardial injection of Ringer's solution, and Group B included rabbits receiving intrapericardial injection of 3% sodium carboxymethoyl cellulose solution. Three weeks after the surgery, the incidence of adhesions in Group A was compared with that in Group B. Result; Pericardial adhesions were evaluated by tenacity and type scores. Tenacity scores of 3 or greater were considered clinically significant adhesion. Pericardial adhesion was found in 100% of rabbits in group A. However 25% of the rabbits in Group B had pericardial adhesions(p<0.0001). Type scores were also considered clinically significant between 2 groups. Conclusion; Our findings demonstrated that intrapericardial injection of 3% sodium carboxymethyl cellulose solution reduced the incidence of pericardial adhesions in an animal models.