• Journal of Korean Neurosurgical Society
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• 제58권4호
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• pp.393-396
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• 2015

Bullet injuries to the spine may cause injury to the anatomical structures with or without neurologic deterioration. Most bullet injuries are acute, resulting from direct injury. However, in rare cases, delayed injury may occur, resulting in claudication. We report a case of intradural bullet at the L3-4 level with radiculopathy in a 30-year-old male. After surgical removal, radicular and claudicating pain were improved significantly, and motor power of the right leg also improved. We report the case of intradural bullet, which resulted in delayed radiculopathy.

• Journal of Trauma and Injury
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• 제30권2호
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• pp.51-54
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• 2017

We here report a case of long-term fistula formation due to bullet retention for 30 years in the lumbar spine after a gunshot injury, and describe its treatment. A 62-year-old male visited our hospital due to pus-like discharge from his left flank. The discharge had been present for 30 years, since his recovery from an abdominal gunshot injury. A spine radiography showed radiopaque material in the body of the third lumbar vertebra. Foreign body was removed using an anterolateral retroperitoneal approach. The postoperative course was uneventful. The patient was discharged 7 days after the operation and was followed-up for 8 months, during which time, the fistula did not reoccur. A bullet retained long term in the vertebral body may cause obstinate osteomyelitis and fistula formation. A fistula caused by a foreign body in the spine can be effectively treated by surgical removal.

• Journal of Trauma and Injury
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• 제33권4호
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• pp.275-278
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• 2020

A 24-year-old man presented to King Saud Medical City emergency department with a retained bullet in his penis following a civilian exchange of gunfire. After an initial assessment, the patient was taken to the operating room. Penile exploration was performed, the bullet was extracted successfully, and the corpora cavernosa were repaired properly. A 6-week follow-up showed full healing with preservation of erectile function. Immediate surgical intervention is mandatory as the primary treatment for penile gunshot injury to ensure proper anatomical and functional recovery.

• Journal of Trauma and Injury
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• 제34권1호
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• pp.66-69
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• 2021

When treating firearms injuries, knowledge of the proper management is important because these injuries have high morbidity and mortality. However, due to strict gun safety regulations, surgeons in Asia often have limited experiences with gunshot wound management. Recently, the authors had the experience of removing a bullet that did not cause hemopneumothorax, but remained in the lung parenchyma. Due to the risk of complications that could occur if the bullet was not removed, surgical treatment was eventually performed to remove the bullet. A literature review was needed to determine whether this treatment was appropriate. We concluded that removing the bullet could prevent incidental complications. In this regard, the authors report a case along with a review of the relevant literature to suggest appropriate treatment directions for surgeons who do not have experience with gunshot wounds.

• Journal of Trauma and Injury
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• 제37권3호
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• pp.233-237
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• 2024

Bullet embolism is a potential complication of a gunshot wound, especially with a low-velocity missile. This is because the trajectory of the low-velocity bullet can be significantly slowed as it passes through tissue. An unusual form of travel can occur in which the bullet enters the vasculature but does not have enough kinetic energy to create a through-and-through wound, leading it to remain inside the vasculature. Once inside the vasculature, the bullet could migrate to different parts of the body, potentially causing complications such as ischemia, becoming a source of thromboembolism, or functioning as a nidus for infection. The management of a bullet embolism varies from case to case, as each patient with this issue has a unique body habitus that can result in infinite possibilities of the trajectory and destination of the bullet embolus. Additional damage to surrounding vasculature or tissue can occur, as well as embolization of the bullet to critical areas of the body. Here we present the case of a 72-year-old man who had a self-inflicted gunshot wound to the chest with a low-velocity bullet, which penetrated the right atrium of the heart. It traveled into the venous vasculature through the right atrium, into the inferior vena cava, and eventually settled in the right internal iliac vein. He refused further intervention and management after initial workup and resuscitation.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.253-257
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• 2023

A century ago, cardiac injuries usually resulted in death. However, despite all the advances in medicine, these injuries still have high mortality and morbidity rates. In the present case, we describe a patient with a bullet injury to the right ventricle who survived at our hospital despite the limitations of our center with regard to modalities and equipment. A 30-year-old man was brought to our emergency department with a bullet wound to his left flank. He was hemodynamically unstable. After only 8 minutes in the hospital and without further investigations he was rushed to the operating room. During laparotomy, a clot was visible in the left diaphragm, which dislodged and caused extensive bleeding. The decision was made to perform a sternotomy in the absence of a sternal saw. An oblique 8-cm injury to the right ventricle was discovered following rapid exploration. It was repaired without the need for cardiopulmonary bypass surgery. After a few days in the hospital, the patient was discharged home. In the event of a penetrating cardiac injury, rapid decision-making is crucial for survival. Whenever possible, the patient should be transferred to the operating room, as emergency department thoracotomies are associated with a high mortality rate.

• Journal of Korean Neurosurgical Society
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• 제66권5호
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• pp.598-604
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• 2023

Penetrating head injury is a serious open cranial injury. In civilians, it is often caused by non-missile, low velocity flying objects that penetrate the skull through a weak cranial structure, forming intracranial foreign bodies. The intracranial foreign body can be displaced due to its special quality, shape, and location. In this paper, we report a rare case of right-to-left displacement of an airgun lead bullet after transorbital entry into the skull complicated by posttraumatic epilepsy, as a reminder to colleagues that intracranial metal foreign bodies maybe displaced intraoperatively. In addition, we have found that the presence of intracranial metallic foreign bodies may be a factor for the posttraumatic epilepsy, and their timely removal appears to be beneficial for epilepsy control.

• Journal of Trauma and Injury
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• 제35권4호
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• pp.277-281
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• 2022

Craniocerebral gunshot injuries is gradually increasing in the civilian population with a worse prognosis than closed head trauma. We experienced a case of craniocerebral gunshot injury which a bullet penetrating from the submandibular area into the clivus of a patient. The patient did not show any symptom. However, serial laboratory findings showed an increase in blood lead level. We removed foreign bodies without any problems using an endoscopic transnasal transclival approach. Due to the extremely low frequency, guidelines for definitive management of gunshot injuries have not been presented in Korea yet. We introduce our surgical experience of a craniocerebral gunshot injury with an unusual approach for removing intracranial foreign bodies.

• 한국산학기술학회논문지
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• 제21권5호
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• pp.615-622
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• 2020

파쇄 탄두는 목표물에 충격시 탄두가 파쇄되어 사격 연습이나 댐, 핵발전소, 문화재 등 중요 시설에서 이루어지는 작전에서 파편의 도비로 인한 2차적인 피해를 줄일 수 있다. 최근에는 납(Lead)이 함유된 탄두로 인하여 사격장에서 발생하는 환경 유해물질을 줄이는 것이 정부와 환경단체에서 중요한 이슈로 부각되고 있다. 본 연구에서는 파쇄 탄두의 국내 개발 확대를 위해 파쇄탄의 효율적인 탄두 형상을 설계하였으며, 안전성과 신뢰성 확인을 위한 시험 진행 및 공정 조건별 실사격을 통한 실제 파편의 크기 확인을 진행하였다. 또한 소결된 파쇄탄자의 미세조직 사진 분석을 통해 공정별 압축강도, 밀도 및 파쇄성 등 물리적인 특성을 비교하였다. 본 실험을 통해 조성 성분 Cu-Sn 에서 조성 비율 - 85:15/소결온도 : 600℃/ 소결시간 : 1시간 조건에서 탄두의 정상적인 발사 및 목표물에 충격 후 최소의 파편으로 분쇄되는 최적의 결과를 나타내는 것을 확인했다. 본 연구를 기반으로 공정 조건 및 실험 방법 등을 더 발전시켜 향후 파쇄탄자의 성능개량 및 환경 개선 등에 기여할 수 있을 것이라 생각한다.

• Journal of Korean Neurosurgical Society
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• 제51권3호
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• pp.164-166
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• 2012

Penetrating injuries to the upper cervical spine resulting from gunshots are rare in South Korea due to restrictions of gun use. Moreover, gunshot wounds to the upper cervical spine without neurological deficits occur infrequently because of the anatomic location and surrounding essential structures. We present an uncommon case involving the surgical removal of a bullet located in the anterior arch of first cervical vertebra (C1) via a transoral approach without neurological complications or subsequent mechanical instability.