• Title/Summary/Keyword: Early rupture

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Clinical Results of Treatment of Distal Biceps Rupture (이두박근 원위부 파열의 임상적 치료 결과)

  • Chung, Duke-Whan;Hwang, Jung-Chul
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.13-18
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    • 2009
  • Purpose: To report the clinical results of patients treated for a rupture of the distal tendon of biceps brachii Materials and Methods: Between February 1987 and March 2004, we treated 16 patients with a rupture of the distal tendon of biceps brachii. 9 of 16 patients underwent surgical treatment. All cases were male, median age was 26.3(range, 16-48) years. The mean interval between injury and surgery was 4.7 days (range, 1~36 days). Operative correction was performed anatomically, using the two-incision technique(3 cases) or one-incision technique(6 cases). Clinical outcomes were evaluated one year after operation by assessing the review about the physical examination finding and radiologic findings with surgical findings, range of motion, muscle strength, subjective satisfaction, activity and return to previous occupation. and via telephone interview in cases of conservative treatment. Results: In cases of surgical treatment, 85.8%, 86.3% of flexion-extension and supination-pronation motion than healthy side were measured respectively. 75% of flexion power than healthy side was measured. Eight of nine(89%) were very satisfied. Eightl of nine returned to original job. In cases of conservative treatment, 65% of flexion power than pre-injury state was reported. Four of seven were satisfied, two were dissatisfied, one was very dissatisfied. Three of seven returned to original job. Conclusion: Early anatomic reconstruction can restore more strength and endurance for supination and flexion range and power. Conservative management may be considered for partial injuries, but operative repair must be considered in complete rupture, athletes, patient with high activity.

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Intramural Pregnancy after in vitro Fertilization and Embryo Transfer (체외수정 시술 후 발생한 자궁벽내 임신 1예)

  • Cha, Sun-Hwa;Park, Chong-Taik;Kim, Hae-Suk;Song, Hyun-Jung;Kang, Eun-Hee;Song, Hyun-Jin;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.31 no.4
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    • pp.273-277
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    • 2004
  • Intramural pregnancy is an unusual ectopic gestation located within the uterine wall, completely surrounded by myometrium and separate from the uterine cavity, fallopian tube, or round ligament. It is known to be difficult to diagnose, and associated with a high rate of uterine rupture. We report a case of intramural pregnancy in which early diagnosis was made and successful treatment was done by dilatation and curettage. Diagnostic laparoscopy confirmed the absence of uterine rupture during the procedure. Therefore, conservation of fertility can be possible with early diagnosis of intramural pregnancy. To our knowledge, this is the first case report of intramural pregnancy following IVF-ET in Korea.

Limited Open Repair Technique of Achilles Tendon Ruptures - Operative Technique and Early Results - (최소 절개 봉합술을 이용한 아킬레스건 파열의 치료 - 수술 방법 및 초기 결과 -)

  • Lee, Keun-Bae;Park, Yu-Bok;Kim, Byung-Soo;Choi, Jin;Jung, Sung-Taek
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.37-41
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    • 2006
  • Purpose: To investigate the early results of limited open repair technique of Achilles tendon ruptures, and to describe the surgical technique. Materials and Methods: From October 2004 to February 2005, a total of 10 patients with Achilles tendon rupture underwent limited open repair. The average age of the patients was 39.3 years, and the average follow-up period was 9 months. The causes of injury were sports injuries in 8 cases, and slip down in 2. The mean interval between the injury and the operation was 9 days. The clinical results were assessed by patient's satisfaction, incision length, hospitalization, the ankle-hindfoot scale of American Foot and Ankle Society (AOFAS), and complications. Results: Of 10 patients, 8 were very satisfied, and the remaining 2 were satisfied. The mean incision length was 2.0 cm, and the mean hospitalization was 2 days. The mean AOFAS score was 97 points, and there was no complications such as infection, rerupture, or nerve injury. All patients returned to work at approximately 2 months, and resumed light exercise such as jogging at approximately 3 months. Conclusion: Limited open repair technique of Achilles tendon ruptures is provided for better cosmetic results, high patient's satisfaction, and functionally successful results without postoperative complications.

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Surgical Complications and Its Management in Intracranial Aneurysm (두개강내 뇌동맥류에서 수술적 합병증 및 치료)

  • Han, Jong Woo;Hwang, Soo Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1113-1120
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    • 2000
  • Objectives : Despite advance in the surgical treatment of the intracranial aneurysm, we have to be surgical complication. The aim of this report is to evaluate the complication and its management in intracranial aneurysm operation. Methods : We reviewed our exprience with interesting cases of surgical complication of intracranial aneurysm : 1) rebleeding, 2) intra-operative premature rupture, 3) missed aneurysm in angiography, 4) vasospasm. Results : The risk of rebleeding was not related to the patients' initial comdition, but all other intracranial complications occurred significantly more often in patients graded poor compared with patients in good clinical condition. Rebleeding before early surgery remains as major cause of unfavorable outcome. The causes of intraoperative premature ruptures were as follows : 1) dural opening and arachnoid opening(8.3%), 2) hematoma removal(12.5%), 3) brain retraction(16.7%) 4) aneurysm dissection(62.5%). The double suction technique and primary hemostasis using a small piece of cotton or temporary clip resulted in good outcome even in cases with premature rupture. The incidence of missed aneurysm in angiography occurred in 10%. The causes were as thrombosed aneurysm, vasospasm on feeder artery. The most common missed aneurysm is also the most common aneurysm(anterior communicating artery aneurysm). The repeated angiography were documented in missed aneurysm. Balloon angioplasty is superior topapaverine for treatment of proximal vessel vasospasm by viture of a more sustained effect on the vessel. Papaverine can be useful as an adjunct to ballon angioplasty and also for the treatment of distal vessels that are not accessible for ballon angioplasty. Conclusion : The minimization of the complications and active treatment can reduced the mortality and morbidity of ruptured aneurysm patients.

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Surgical Treatment of Ahilles Tendon Rupture Using Modified Lynn Method (변형 Lynn씨 방법에 의한 아킬레스건 파열의 수술적 치료)

  • Kang, Jae-Do;Kim, Kwang-Yul;Kim, Hyung-Chun;Kim, Jin-Hyung;Choi, Shin-Kwon
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.223-231
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    • 2003
  • Purpose: Achilles tendon rupture has become more common in the recent years. As suture with foreign material has been blamed for impaired healing, better results should be expected from the use of autogenous material such as plantaris tendon. We have evaluated the surgical results of end-to-end anastomosis using the plantaris tendon as suture material. Materials and Methods: Between Jan 1997 and Jan 2002, the 60 patients were included this study during one year follow-up. We performed the operations with end-to-end suture technique using modified Lynn's method. The plantaris tendon has been used as a autogenous suture material and can be utilized in the end-to-end anastomosis of ruptured Achilles tendon with modifed Bunnel suture technique. We used a clinical scoring system reported by Leppilahti to evaluate the results. Results: The overall results were excellent in thirty eight(63.3%), good in sixteen(26.6%), fair in five(8.3%) cases, and poor in only one (1.6%) case. Fifty four cases(90%) had the score more than good. We had no deep infection, rerupture, deep vein thrombosis, and skin necrosis as major complication. In just 2 cases, although there were superficial skin infection, the wounds did not proceed necrosis due to using antibiotics. Conclusion: End-to-end anastomosis using the plantaris tendon as suture material was good treatment option that had low infection rate and no foreign body reaction because of using autogenous material, and therefore we can get rapid healing of ruptured tendon due to early ragne of motion and accerlerated rehabilitation.

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Recurrent Thrombosis After Arterial Repair at the Wrist (손목의 동맥 문합술 후 반복적 혈전형성)

  • Cho, Yong Hyun;Roh, Si Gyun;Lee, Nae Ho;Yang, Kyung Moo
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.667-669
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    • 2009
  • Purpose: Radial and ulnar arteries are two major arteries responsible for the blood supply of the hand. We experienced early recurrent thrombosis of ulnar artery after arteriorrhaphy in a patient with rupture of ulnar and radial arteries due to glass injury. Thus, we thought this would require reviews. Method: 41 - year - old female patient was presented for the laceration of right wrist due to glass injury. Operative findings revealed the rupture of radial artery, ulnar artery, ulnar nerve and most of the flexor tendons. We performed three consecutive operations because of the recurrent arterial thrombosis in ulnar artery. Arteriorrhaphy was performed in each operation and the interpositional vein graft was performed in the final operation. Result: Consequently, doppler ultrasonography was performed on twentieth postoperative day and fair flow in the ulnar artery was visualized. Pathologic examination of the artery revealed no histopathologic abnormalities. Conclusion: It is not a matter of ease to follow up the patients with rupture of radial or ulnar arteries. Obstruction of the repaired artery is also not easy to detect because it usually presents no definite symptoms. We could detect the obstruction of the artery following arteriorrhaphy with the doppler ultrasonography in less than a week postoperatively, and repeated operations were followed. We reviewed the causes and factors affecting the thrombosis and hereby report with literature review.

Post-Infarction Ventricular Septal Rupture : 10 Years of Experience (급성 심근경색증 후 심실중격 결손: 10년 경험)

  • Jung, Yo-Chun;Cho, Kwang-Ree;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.351-355
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    • 2007
  • Background: Postinfarction ventricular septal rupture is associated with mortality as high as $85\sim90%$, if it is treated medically. This report documents our experience with postinfarction ventricular septal rupture that was treated surgically, Material and Method: We retrospectively reviewed the medical records of 11 patients who were operated on due to postinfarction ventricular septal rupture between August 1996 and August 2006. There were 4 men and 7 women, with a mean age of $70{\pm}11$ years (age range: $50\sim84$ years). The location of the rupture was anterior in 7 cases and posterior in 4 cases. The interval between the onset of acute myocardial infarction and the occurrence of the ventricular septal rupture was $2.0{\pm}1.3$ days (range: $1\sim5$ days). Operation was performed at an average of $2.4{\pm}2.7$ days (range: $0\sim8$ days) after the diagnosis of septal rupture. Preoperative intraaortic balloon pump therapy was performed in 10 patients. Result: The infarct exclusion technique was used in all cases. Coronary artery bypass grafting was done in 8 cases, with the mean number of distal anastomosis being $1.0{\pm}0.8$. There was one operative death. In 2 patients, reoperation was performed due to a residual septal defect. The postoperative morbidities were transient atrial fibrillation (n=7), paroxysmal supraventricular tachycardia (n=1), low cardiac output syndrome (n=3), bleeding reoperation (n=2), delayed sternal closure (n=2), acute renal failure (n=2), pneumonia (n=1), intraaortic balloon pump-related thromboembolism (n=1), and transient delirium (n=2). Nine patients have been followed up for a mean of $38{\pm}40$ months except for one follow-up loss. There have been 3 late deaths. At the latest follow-up, all 6 survivors were in a good functional class. Conclusion: We demonstrated satisfactory operative and midterm results with our strategy of preoperative intraaortic balloon pump therapy, early repair of septal rupture by infarct exclusion and combined coronary revascularization.

On the Understanding of Infinity (무한 개념의 이해에 관하여)

  • Hong, Jin-Kon
    • Journal of Educational Research in Mathematics
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    • v.18 no.4
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    • pp.469-482
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    • 2008
  • This study analysed difficult points on the understanding of infinity when the concept is considered as actual infinity or as potential infinity. And I consider examples that the concept of actual infinity is used in texts of elementary and middle school mathematics. For understanding of modem mathematics, the concept of actual infinity is required necessarily, and the intuition of potential infinity is an epistemological obstacle to get over. Even so, it might be an excessive requirement to make such epistemological rupture from the early school mathematics, since the concept of actual infinity is not intuitive, derives many paradoxes, and cannot offer any proper metaphor.

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Advanced In-Vessel Retention Design for Next Generation Risk Management

  • Kune Y. Suh;Hwang, Il-Soon
    • Proceedings of the Korean Nuclear Society Conference
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    • 1997.10a
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    • pp.713-718
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    • 1997
  • In the TMI-2 accident, approximately twenty(20) tons of molten core material drained into the lower plenum. Early advanced light water reactor (LWR) designs assumed a lower head failure and incorporated various measures for ex-vessel accident mitigation. However, one of the major findings from the TMI-2 Vessel Investigation Project was that one part of the reactor lower head wall estimated to have attained a temperature of 1100$^{\circ}C$ for about 30 minutes has seemingly experienced a comparatively rapid cooldown with no major threat to the vessel integrity. In this regard, recent empirical and analytical studies have shifted interests to such in-vessel retention designs or strategies as reactor cavity flooding, in-vessel flooding and engineered gap cooling of the vessel Accurate thermohydrodynamic and creep deformation modeling and rupture prediction are the key to the success in developing practically useful in-vessel accident/risk management strategies. As an advanced in-vessel design concept, this work presents the COrium Attack Syndrome Immunization Structures (COASIS) that are being developed as prospective in-vessel retention devices for a next-generation LWR in concert with existing ex-vessel management measures. Both the engineered gap structures in-vessel (COASISI) and ex-vessel (COASISO) are demonstrated to maintain effective heat transfer geometry during molten core debris attack when applied to the Korean Standard Nuclear Power Plant(KSNPP) reactor. The likelihood of lower head creep rupture during a severe accident is found to be significantly suppressed by the COASIS options.

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Perforated Early Gastric Cancer: Uncommon and Easily Missed a Case Report and Review of Literature

  • Lim, Raymond Hon Giat;Tay, Clifton Ming;Wong, Benjamin;Chong, Choon Seng;Kono, Koji;So, Jimmy Bok Yan;Shabbir, Asim
    • Journal of Gastric Cancer
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    • v.13 no.1
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    • pp.65-68
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    • 2013
  • Gastric carcinoma rarely presents as a perforation, but when it does, is perceived as advanced disease. The majority of such perforations are Stage III/IV disease. A T1 gastric carcinoma has never been reported to perforate spontaneously in English literature. We present a 56 year-old Chinese male who presented with a perforated gastric ulcer. Intra-operatively, there was no suspicion of malignancy. At operation, an open omental patch repair was performed. Post-operative endoscopy revealed a macroscopic Type 0~III tumour and from the ulcer edge biopsy was reported as adenocarcinoma. Subsequently, the patient underwent open subtotal gastrectomy and formal D2 lymphadenectomy. The final histopathology report confirms T1b N0 disease. The occurrence of a perforated early gastric cancer reemphasises the need for vigilance, including intra-operative frozen section and/or biopsy, as well as routine post-operative endoscopy for all patients.